重组人血管内皮抑制素联合肝动脉化疗栓塞治疗原发性肝细胞癌52例分析

目的研究重组人血管内皮抑制素联合肝动脉化疗栓塞（TACE）治疗原发性肝细胞癌（HCC）的效果。方法选择原发性HCC患者52例，按随机数字表法分为联合组和对照组，每组26例，两组均采用TACE治疗，联合组在栓塞乳剂中加入重组人血管内皮抑制素，对比两组近期有效率、血清血管内皮生长因子（VEGF）水平、不良反应、复发率和生存率。结果联合组有效率（RR）和疾病控制率（DCR）分别为57．69％（15／26）、84．62％（22／26），对照组RR和DCR分别为34．62％（9／26）、73．08％（19／26），两组RR（x^2=5．237，P〈0．05）和DCR（r=4．284，P〈0．05）比较差异均有统计学意义。TACE术后第7，14，28天，联合组和对照组血清VEGF水平变化呈现先上升后下降的趋势，差异均有统计学意义（P〈0．05），联合组血清VEGF水平显著低于对照组（P〈0．05）。随访率94．23％（49／52），联合组术后1，2年复发率均显著低于对照组（P〈0．05），联合组术后2，3年生存率均显著高于对照组（P〈0．05）。结论在TACE术中加用重组人血管内皮抑制素能够有效抑制患者血清VEGF水平上升，提高近期RR和DCR，抑制VEGF可能减少肿瘤近期复发，提高生存率。

The clinical analysis of recombinant human endostatin hormone combined with transcatheter arterial chemoemboUzation of primary hepatocellular carcinoma for 52 patients

Objective To study the effect of recombinant human endostatin hormone combined with transeatheter arterial chemoembolization （TACE） for the treatment of primary hepatocellular carcinoma （HCC）. Methods Fifty-two primary HCC patients were divided into combined group （26 patients） and control group （26 patients） by random digits table method. The patients in combined group received TACE and recombinant human endostatin hormone added in embolism emulsion. The recent curative effect, level of serum vascular endothelial growth factor （VEGF）, adverse reactions, recurrence rate and survival rate were compared between two groups. Results The response rate（RR） and clinical benefit rate（DCR） in combined group were 57.69%（15/26）, 84.62%（22/26）, in control group were 34.62%（9/26）, 73.08%（19/26） ,there were significant differences （ X^2 = 5.237,P 〈 0.05; X^2 = 4.284,P 〈 0.05）. The 7th, 14th, 28th day after TACE ,the level of VEGF in two groups was first increased and then a downward trend, the difference were statistically significant （P 〈 0.05 ）. The level of VEGF in combined group was significantly lower than that in control group （P 〈 0.05 ）. The follow up rate was 94.23% （49/52）, the 1-year and 2-year recurrence rate in combined group was significantly lower than that in control group （P 〈 0.05）. The 2-year and 3-year survival rate in combined group was significantly higher than that in control group （P 〈 0.05）. Conclusion With TACE plus recombinant human endostatin hormone can effectively inhibit the increase of serum VEGF level,improve curative effect and disease control rate, reduce tumor recurrence and improve survival rate.