经皮肝动脉化疗栓塞术后联合阿帕替尼或索拉非尼对原发性肝癌患者甲胎蛋白的影响

目的]探讨经皮肝动脉化疗栓塞术(TACE)后联合阿帕替尼或索拉非尼对原发性肝癌(HCC)患者甲胎蛋白(AFP)水平的影响.方法]本院收治的HCC患者60例,随机分为两组,索拉非尼组给予TACE后联合索拉非尼治疗,阿帕替尼组给予TACE后联合阿帕替尼治疗,比较两组患者治疗后的临床疗效.结果]阿帕替尼组客观缓解率为56.67%(17/30),与索拉非尼组的53.33%(16/30)比较差异无显著性(P>0.05).两组治疗前AFP、热休克蛋白90α(Hsp90α)、血管内皮生长因子(VEGF)水平组间比较差异无显著性(P>0.05),治疗后两组AFP、Hsp90α、VEGF水平均较治疗前下降(P<0.05),但两组之间各项指标比较差异无显著性(P>0.05).所有患者均未发生Ⅳ级不良反应,阿帕替尼组皮肤黏膜反应发生率(73.33%)、高血压发生率(56.67%)高于索拉非尼组,骨髓抑制发生率(46.67%)、胃肠道反应发生率(53.33%)与索拉非尼组比较差异无显著性(P>0.05).结论]TACE后联合阿帕替尼或索拉非尼治疗HCC疗效相似,均可降低AFP、Hsp90α、VEGF的表达水平,其中索拉非尼安全性较阿帕替尼高.

Effect of TACE Combined with Apatinib or Solafinib on Alpha-fetoprotein in Patients with Hepato-cellular Carcinoma

Objective]To investigate the effect of transcatheter arterial chemoembolization(TACE)combined with apatinib or Solafinib on alpha fetoprotein(AFP)in patients with Hepatocellular Carcinoma(HCC).Methods]A total of 60 patients with HCC admitted to our hospital from July 2015 to April 2019 were randomly divided into two groups.The solafinib group(n=30)was treated with TACE combined with solafinib,while the apatinib.group was treated with TACE combined with apatinib.The clinical efficacy of the two groups was analyzed.Results]There was no significant difference in objective remission rate between the apatinib group(56.67%)and the solafinil group(53.33%)(P>0.05).The levels of AFP,heat shock protein 90 a(Hsp90 a)and vascular endothelial growth factor(VEGF)between the two groups before treatment were not significantly different(P>0.05).After.treatment,the levels of AFP,Hsp90 a and VEGF in the two groups were lower than those before treatment(P<0.05).However,there was no significant difference in the levels of AFP,Hsp90 a and VEGF between the apatinib group and the solafinil group after treatment(P>0.05).No patients had gradeⅣadverse reactions in.both groups.The incidence of skin and mucous membrane reaction(73.33%)and hypertension(56.67%)in the apatinib group were higher than those in the solafinil group.The incidence of bone marrow suppression(46.67%)and gastrointestinal reaction(53.33%)of the apatinib group were not significantly different from those of the solafinil group(P>0.05).Conclusion]After TACE,the efficacy of apatinib or solafinib in the treatment of HCC is similar showing that the expression of AFP。Hsp90a and VEGF was decreased,however,the safety of solafinib was relatively higher than that of apatinib.