Jinlong capsule decreases adverse reactions after transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma

Objective The aim of this study was to analyze whether Jinlong capsule could decrease adverse reactions after transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma. Methods Eighty-two patients with hepatocellular carcinoma were randomly divided into the control group and experimental group. On the first day after TACE, the experimental group started receiving four Jinlong capsules orally three times daily, whereas the control group did not receive the treatment.Results The incidences of erythropenia and thrombocytopenia in the experimental group was lower than those in the control group(P = 0.040 and 0.033, respectively). The differences in serum levels of aminotransferase, albumin, potassium, and sodium between the two groups were significant(P = 0.034, 0.034, 0.013, and 0.044, respectively). The mean durations of stomachache and abdominal distension in the experimental group was significantly shorter than those in the control group(P = 0.004 and 0.021, respectively). However, there were no significant differences in the incidences of nausea, fever, and vomiting between the two groups(P = 0.490, 0.495, and 0.585, respectively). Conclusion The reduction in the incidence rate and duration of partial adverse reactions after TACE was observed in hepatocellular carcinoma patients treated with Jinlong capsule compared to untreated patients, suggesting possible beneficial effects exerted by Jinlong capsule on the reduction of TACE-induced liver damage, thereby improving liver function and, consequently, the quality of life.     

Effects of kanglaite capsules combined with transcatheter arterial chemoembolization （TACE） on patients with mid or late-stage primary hepatocellular carcinoma （HCC）

Objective:To observe the clinical effects of kanglaite (KLT)capsules combined with transcatheter arterial chemo- embolization(TACE)in treating patients with mid or late-stage primary hepatocellular carcinoma (HCC).Methods:Sixty-five cases were randomly divided into 2 groups.32 patients in combination group received the treatment of KLT capsules+TACE and 33 patients in control group were treared with TACE alone.The objective response rate(RR).serum alpha fetoprotein (AFP),peripheral blood T lymphocyte subgroups(T-LS),quality of life(QOL),time to progression(TTP)and adverse reaction were observed and compared between 2 groups.Results:The objective response rate and serum alpha fetoprotein levels had no significant difference between the two groups (P＞0.05).Combination group was superior to control group in quality of life(QOL).time to progression(TTP),peripheral blood T lymphocyte subgroups(CD3+,CD4+,CD4+＼CD8 ratio)and liver adverse reactions,with significant differences (P＜0.05).Conclusion:KLT capsules combined with TACE is an effective method to treat primary hepatocellular carcinoma (HCC) patients who have lost the opportunity of surgical therapy.     

γ-刀联合射频热疗治疗原发性肝癌TACE术后患者的疗效

目的:探讨伽马刀联合热疗对原发性肝癌肝动脉化疗栓塞术（TACE）后患者的临床疗效。方法:63例原发性肝癌患者均已行TACE术治疗,治疗后4周采用随机数字表分为治疗组（伽马刀联合热疗）和对照组（单纯伽马刀治疗）,两组在年龄、性别、卡氏评分等方面,差异无统计学差异（P＞0.05）。放疗为4 000~6 600cGy/20~33f,每次200cGy,热疗为每周2次,每次间隔72小时,8次/疗程,热疗于放疗结束后即进行,观察KPS评分、近期疗效、生存率及不良反应,随访时间截止2012年8月。结果:治疗组有效率（CR+PR）70.59%（24/34）,局部控制率（CR+PR+SD）91.18%,治疗组0.5、1、2、3年生存率分别为88.23%、79.41%、41.17%、17.64%;对照组有效率58.62%（17/29）,局部控制率79.31%,对照组0.5、1、2、3年生存率分别为82.55%、62.06%、20.69%、6.90%,经比较两组有效率有统计学差异（P＜0.05）,局部控制率无统计学差异（P＞0.05）,1、2、3年生存率有统计学差异（P＜0.05）。治疗组在KPS评分、AFP方面改善程度明显优于对照组,有统计学差异（P＜0.05）。结论:原发性肝癌TACE术后行伽马刀联合热疗较单纯放疗可显著提高患者近期临床缓解率,延长生存期,提高患者功能评分KPS,降低AFP程度,不增加不良反应。     

Prognostic value of splenic volume in hepatocellular carcinoma patients receiving transarterial chemoembolization

BackgroundLiver function is a key determinant for the survival of hepatocellular carcinoma (HCC) patients receiving transarterial chemoembolization (TACE). However, establishing robust prognostic indicators for liver insufficiencies and patient survival remains an unmet demand. This retrospective study evaluated the prognostic value of splenic volume (SV) in HCC patients undergoing TACE.MethodsA total of 67 HCC patients who underwent at least two consecutive TACE procedures were retrospectively included in this study. Comprehensive clinical information and follow-up data were collected, and the SV was measured based on dynamic contrast enhanced images. Risk factors of SV enlargement were assessed. The prognostic value of SV on survival was analyzed and compared with Child-Pugh (CP) classification and albumin-bilirubin (ALBI) grade.ResultsThe baseline SV was 299.74±143.63 cm³, and showed a moderate and statistically significant correlation with CP classification (R=0.31, P<0.05). The SV increased remarkably after the first and second TACE procedures (330.16±155.38 cm³, P<0.01, and 355.63±164.26 cm³, P<0.01, respectively). In survival analysis, the optimal cut-off value of SV was determined as 373 cm³ using X-tile software, and the patients were divided into the small SV group and the large SV groups accordingly. Based on the pre-TACE SV, the median overall survival (mOS) for patients in the small SV group and the large SV group was 458 days and 249 days, respectively (P<0.05). After the first and second TACE, the mOS in the small SV group and the large SV group were 454 vs. 266 days (P<0.05) and 526 vs. 266 days (P<0.05), respectively. No prognostic value of CP classification and ALBI grade was identified for these patients. Furthermore, there were no significant differences between the small and large SV groups in age, tumor stage, and ALBI grade, except for CP classification (P<0.05).ConclusionsSV was correlated with CP classification and was a robust predictor for HCC patients undergoing TACE treatment.     

微波消融术联合肝动脉介入栓塞术治疗肝细胞癌的临床研究

目的：比较微波消融术（ microwave ablation,MWA）联合或者不联合经肝动脉化疗栓塞术（ transcathe-ter arterial chemoembolization,TACE）治疗肝细胞癌（ HCC）的临床疗效以及不良反应。方法：选择89例2006年10月至2009年7月入我院治疗的肿瘤直径≤5cm的原发性肝细胞癌患者,采用随机数字法分为MWA联合TACE组（n=44）或者单独MWA组（n=45）进行随机对照研究,观察两组患者的总生存率（OS）、无复发生存率（ RFS）以及不良反应。结果：所有患者均治疗成功,随访时间为7-62个月,随访结束时联合组患者死亡15人,微波组死亡23人。联合组、微波组分别有16人、25人出现疾病进展。1年、2年、3年OS分别为86.4%,74.4%,61.8%和77.4%,63.6%,50.0%。对应的RFS为72.4%,61.6%,45.8%和61.7%,52.2%,39.8%。联合组的OS以及RFS高于单纯微波组（风险比率HR为0.323,95%CI为0.295-0.351,P=0.002;风险比率HR为0.258,95%CI为0.230-0.286,P=0.02）。研究过程中无治疗相关性死亡。对相关因素进行Logistic回归分析,治疗分配、肿瘤大小、肿瘤数目是OS相关预后因素,治疗分配、肿瘤大小是RFS相关预后因子。结论：MWA联合TACE术治疗病灶≤5cm的HCC患者疗效优于单独的MWA治疗疗效。     

Development of a prognostic score for recommended transarterial chemoembolization candidates with spontaneous rupture of hepatocellular carcinoma

BackgroundAlthough transarterial chemoembolization (TACE) has been widely used for treating the spontaneous rupture of hepatocellular carcinoma (HCC), no existing model exists for predicting survival. The aim of this study was thus to develop and validate a nomogram for estimating the prognosis in patients with ruptured HCC upon undergoing TACE treatment.MethodsThis study included 55 patients with spontaneously ruptured HCC who underwent TACE treatment between January 2015 and April 2019. The diagnosis of spontaneous HCC rupture was based on the disruption of the peritumoral liver capsule with surrounding fluid in the perihepatic region. The prognostic nomogram was constructed using the independent predictors assessed by the multivariate Cox proportional hazards model.ResultsThe median overall survival (OS) was 6.4 months, with 6-month and 1-year survival rates of 52.7% and 41.8%, respectively. In the univariate analysis, the size of the largest tumor, total bilirubin (TBIL) levels, and aspartate aminotransferase (AST) levels were associated with the OS of patients. Multivariate analysis suggested that TBIL levels (HR =0.358, P=0.036) and diameter of the largest tumor (HR =1.012, P=0.044) were independent prognostic factors for predicting the OS. Based on these variables, we developed and validated a nomogram for the risk stratification of HCC rupture after TACE treatment for individual patients. According to the nomogram risk assessment, we were able to evaluate the approximate 1- and 2-year survival rates based on patients’ tumor diameter and TBIL level after TACE treatment of ruptured HCC. The concordance index for the OS prediction was 0.748 (95% CI: 0.691–0.805). This newly developed nomogram represents an intuitive tool for predicting the OS of patients with ruptured HCC.ConclusionsThis study indicated that TBIL levels and diameter of the largest tumor were independent prognostic factors for predicting the OS of ruptured HCC. This study may help maximize favorable TACE treatment outcomes.     

吡柔比星和阿霉素毒副反应的对比观察

 对含吡桑比星（THP）联合化疗方案施治的71例（183个治疗周期）和合阿霉素（ADM）联合化疗方案施治的106例（269个治疗周期）中晚期恶性肿瘤病人在毒副反应方面的资料进行了对比观察。结果表明，THP组的消化道副反应、脱发、心脏毒性较ADM组明显减轻；骨髓抑制、口腔炎、体温升高、肝肾功能损伤的毒副反应两药基本相当。综合判断，提示THP的毒副反应较ADM轻。     

In vitro evaluation of dichloro-bis(pyrazole)palladium(II) and dichloro-bis(pyrazole)platinum(II) complexes as anticancer agents

Introduction  Cisplatin (cis-diamminedichloroplatinum) was first identified for its anti-bacterial activity, and was later also shown to be an efficient anticancer agent. However, the therapeutic use of this anticancer drug is somewhat limited by its toxic side effects, which include nephrotoxicity, nausea, and vomiting. Furthermore the development of drug-resistant tumours is commonly observed following therapy with cisplatin. Hence there is a need for improved platinum derived drugs to overcome these limitations. Aims  Apoptosis contributes significantly to the cytotoxic effects of anticancer agents such as cisplatin; therefore in this study the potential anticancer properties of a series of pyrazole palladium(II) and platinum(II) complexes, [(3,5-R₂pz)₂PdCl₂] {R = H (1), R = Me (2)} and [(3,5-R₂pz)₂PtCl₂] {R = H (3), R = Me (4)}, were evaluated by assessment of their pro-apoptotic activity. Methods  The induction of apoptosis was measured in CHO cells by the detection of phosphatidylserine (PS) exposure using the annexin V and APOPercentage™ assays; DNA fragmentation using the Terminal deoxynucleotide transferase dUTP Nick End Labelling (TUNEL) assay; and the detection of activated caspase-3. Results  The platinum complexes were shown to be considerably more active than the palladium complexes, with complex 3 demonstrating the highest level of cytotoxic and pro-apoptotic activity. The LD₅₀ values for complex 3 and cisplatin were 20 and 70 μM, respectively, demonstrating that the cytotoxic activity for complex 3 was three times higher than for cisplatin. Various human cancer cell lines, including CaSki, HeLa, as well as the p53 mutant Jurkat T cell line were also shown to be susceptible to complex 3. Conclusions  Collectively, this in vitro study provides insights into action of palladium and platinum complexes and demonstrates the potential use of these compounds, and in particular complex 3, in the development of new anticancer agents.     

肝动脉栓塞化疗联合放疗治疗不能手术的原发性肝癌的临床观察

目的　观察肝动脉栓塞化疗（ＴＡＣＥ）联合直线加速器或全身伽玛刀治疗不能手术的原发性肝癌（ＰＨＣ）的疗效及毒副反应。方法　２００５年７月至２００８年６月,１０８例不能手术的ＰＨＣ患者中５０例行ＴＡＣＥ联合直线加速器放疗（加速器组）,５８例行ＴＡＣＥ联合全身伽玛刀放疗（伽玛刀组）。ＴＡＣＥ灌注化疗药物包括丝裂霉素（ＭＭＣ）１０～２０ｍｇ、氟尿嘧啶（５-ＦＵ）１０００～１５００ｍｇ、表阿霉素（Ｅ-ＡＤＭ）３０～５０ｍｇ,栓塞剂为４０％超液态碘化油５～２０ｍｌ。直线加速器治疗用６ＭＶ Ｘ,９５％等剂量线包绕ＰＴＶ,４０～６０Ｇｙ／１５～２５ｆ,３～５ｆ／周;伽玛刀治疗用月亮神立体定向伽玛射线旋转聚焦全身放射治疗系统（ＬＵＮＡ-ＴＭ-２６０）,４０％ ～６０％等剂量线包绕ＰＴＶ,单次剂量３～６Ｇｙ,３～５ｆ／周,照射总量３０～５０Ｇｙ。联合应用ＴＡＣＥ为１～３个疗程。结果　加速器组及伽玛刀组的中位生存期分别为１４个月和１６个月,中位肿瘤进展时间（ＴＴＰ）分别为７.６个月和８.１个月;２年局部控制率分别为４５.４％和４３.６％（χ^２ ＝０.０２０,Ｐ＝０.８８７）,３年局部控制率分别为３６.５％和３７.９％（χ^２ ＝０.０４０,Ｐ＝０.８４１）;２年生存率分别为４１１％和３９６％（χ^２ ＝０.０２１,Ｐ＝０.８８５）,３年生存率分别为３４.３％和３０.２％（χ^２ ＝０.３６８,Ｐ＝０.５４４）。加速器组中出现１例放射诱发的肝病,伽玛刀组未见相关病例。结论　直线加速器和伽玛刀联合ＴＡＣＥ治疗ＰＨＣ均安全可靠,疗效相当。     

Postoperative adjuvant transarterial chemoembolization for intrahepatic cholangiocarcinoma patients with microvascular invasion: a propensity score analysis

BackgroundMicrovascular invasion (MVI) is an independent risk factor associated with tumor recurrence and poor survival in patients with intrahepatic cholangiocarcinoma (ICC) after partial hepatectomy (PH). The potential impact of adjuvant TACE on the prognosis of patients with ICC involving MVI (ICC-MVI) remains uncertain. Our aim was to investigate the effectiveness of postoperative adjuvant transarterial chemoembolization (TACE) on ICC involving MVI.MethodsMulticentric data consisted of 223 patients who underwent curative-intent PH for ICC-MVI from 2002–2015 were retrospectively analyzed. The impact of adjuvant TACE was evaluated using inverse probability of treatment weighting (IPTW) and propensity-score matched (PSM) analyses.ResultsNo association between the TACE and the overall survival (OS) and recurrence rates was observed among the overall ICC-MVI patients. However, subgroup analyses revealed that adjuvant TACE favored OS (HR, 0.62; 95% CI, 0.39–0.99; P=0.047) and time to recurrence (TTR) (HR, 0.59; 95% CI, 0.36–0.97; P=0.037) among patients with elevated CA19-9 and those without lymphadenectomy (HR, 0.53; 95% CI, 0.30–0.93; P=0.027 for OS, and HR, 0.49; 95% CI, 0.28–0.87; P=0.015 for TTR, respectively). In the CA19-9 ≥39 U/L subgroup and Nx subgroup, adjuvant TACE was associated with higher 1-, 3-, and 5-year OS rates (P=0.033 and P=0.034, respectively) and lower corresponding recurrence rates (P=0.024 and P=0.023, respectively).ConclusionsAmong the ICC-MVI patients undergoing curative-intent PH, only those have elevated CA19-9 or who did not undergo lymphadenectomy might be suitable for adjuvant TACE.     

国产卡铂与顺铂治疗恶性卵巢肿瘤的疗效比较

采用国产卡铂和顺铂治疗恶性卵巢肿瘤６８例，Ⅰｃ期４例，Ⅱ期１１例，Ⅲ期３６例，Ⅳ期５例，复发转移病人１２例，随机分两组：卡铂用药组３７例，腹腔化疗２０例，全身化疗１７例；顺铂用药组３１例，腹腔化疗１８例，全身化疗１１例。卡铂治疗组有效率为５９％；顺铂对照组有效率为５２％，两组有效率相似（Ｐ＞０．０１）。卡铂腹腔化疗组有效率为６０％，略高于其他各组。卡铂组胃肠反应较顺铂组轻，血液系统变化与顺铂组无明显差别，对肾损伤较顺铂轻。卡铂可作为治疗晚期卵巢癌病人的一线药物。     

含奥沙利铂方案ＴＡＣＥ治疗原发性肝癌的临床观察

目的　观察含奥沙利铂方案经皮肝动脉化疗栓塞术（ＴＡＣＥ）治疗中晚期原发性肝癌的疗效和不良反应。方法　２００８年４月至２０１０年４月,３７例患者经手术或活检组织病理诊断以及临床诊断为中晚期原发性肝癌,接受ＴＡＣＥ治疗。动脉灌注药物包括奥沙利铂１３０ｍｇ／ｍ^２,替加氟１５～２０ｍｇ／ｋｇ,肿瘤血管栓塞药物为吡柔比星２５～４０ｍｇ／ｍ^２＋１０～２０ｍｌ进口超液态碘化油乳化剂,部分患者加用明胶海绵栓塞。间隔４～６周复查血常规、肝肾功能、ＡＦＰ、ＣＴ或ＭＲＩ。疗效和不良反应分别按照ＷＨＯ实体瘤近期疗效和抗癌药物急性及亚急性毒性反应分度标准评价。结果　全组３７例患者均顺利完成至少１次ＴＡＣＥ治疗并可评价疗效,获ＣＲ３例（８.１％）,ＰＲ２０例（５４.０％）,ＮＣ１２例（３２.４％）,ＰＤ２例（５.４％）,有效率为６２.２％（２３／３７）,中位无进展生存时间为１３２天（９５％ＣＩ：８９～１７４天）。３７例患者治疗１疗程后肝区疼痛、食欲不振、腹水、黄疸改善率分别为９７.１％、８６.５％、１００.０％和５７.１％。。主要不良反应为发热、恶心、呕吐及骨髓抑制（白细胞减少为主）,大部分均为１～２级,仅５例发生１级神经毒性。结论　含奥沙利铂方案ＴＡＣＥ治疗中晚期原发性肝癌的疗效较好,临床症状显著改善,不良反应轻。     

草酸铂联合氟尿嘧啶和亚叶酸钙治疗晚期大肠癌36例临床观察

目的 观察草酸铂(L-OHP)联合氟尿嘧啶(5-Fu)和亚叶酸钙(CF)治疗晚期大肠癌的近期疗效和毒副反应.方法 经病理组织学诊断的晚期大肠癌36例,用L-OHP 130 mg/m2,静脉滴注4h,每天1次;CF 200 mg,静脉滴注2 d,继以5-Fu 400 mg/m2,dl,d2,静脉滴入,5-Fu600 mg/m2,微量泵入A48 h以上,每3周重复1次,作为1个治疗周期,治疗2个周期后评定疗效.结果 36例总有效率为13例(37.1﹪),完全缓解1例(2.8﹪),部分缓解12例(33.3﹪),无变化14例(38.9﹪),进展9例(25﹪).主要的毒副作用为神经毒性、骨髓抑制、恶心呕吐等,无治疗相关性死亡患者.结论 L-OHP联合大剂量CF及5-Fu治疗晚期大肠癌疗效较好,毒副反应能为患者耐受,值得临床推广应用.     

介入化疗加三维适形放疗治疗胰腺癌的疗效

目的:观察手术不能切除的晚期胰腺癌动脉灌注化疗(TAC)结合三维适形放疗(3D-CRT)的疗效。方法:32例病人先行TAC治疗1～3次,化疗药物为健择1600mg～1800mg,顺铂80mg～100mg。TAC后1～2周行3-DCRT,单次量为2.0Gy,1次/天,肿瘤量55～60Gy。结果:CR1例、PR12例、NC4例、PD4例,有效率(CR PR)为40.6%;1、2年生存率分别为46.87%(15/32)、28.1%(9/32);患者疼痛完全缓解29例,缓解率90.6%(29/32)。结论:对不能切除的胰腺癌行3DCRT与动脉灌注化疗结合是治疗局部进展期胰腺癌的一种有效方法。     

癌胚抗原及铁蛋白联合测定在胃癌诊断中的价值

本文用放射免疫法测定58例胃癌、43例胃起性疾病、24例食管癌患者及158例健康成人血清与胃液中的CEA及Ft。结果表明,胃癌患者血清CEA水平高于正常对照组,P<0.01,但与胃良性疾病及食管癌纽问的差异不明显;胃癌患者血清Ft水平低于各对照组,P<0.01;胃癌患者的胃液CEA及Ft水平均高于各对照组,P<0.01。54例胃癌患者联合测定了血清CEA、胃液CEA及胃液Ft,胃癌胃液中的CEA、Ft双项阳性28例,敏感性为51.85％、特异性为99.04％、阳性诊断价值为96.55％。由此提示,胃液CEA及Ft联合测定有助于胃癌的诊断。     

Phase Ib dose-finding study of abiraterone acetate plus buparlisib (BKM120) or dactolisib (BEZ235) in patients with castration-resistant prostate cancer

BackgroundThe phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signalling axis and androgen receptor (AR) pathways exhibit reciprocal feedback regulation in phosphatase and tensin homologue (PTEN)-deficient metastatic castration-resistant prostate cancer (CRPC) in preclinical models. This phase Ib study evaluated the pan-PI3K inhibitor buparlisib (BKM120) and the dual pan-PI3K/ mammalian target of rapamycin (mTOR) inhibitor dactolisib (BEZ235) in combination with abiraterone acetate (AA) in patients with CRPC.Materials and methodsPatients with CRPC who had progressed on AA therapy received escalating doses of either buparlisib or dactolisib, along with fixed doses of AA (1000 mg once daily (qd)) and prednisone (5 mg twice daily (bid)). The primary objective was to define the maximum tolerated dose (MTD) and/or the recommended dose for expansion (RDE) of either buparlisib or dactolisib in combination with AA. Secondary objectives included safety, antitumour activity (Prostate Cancer Working Group 2 (PCWG2) criteria; 30% of prostate-specific antigen (PSA) decline at ≥week 12) and pharmacokinetic (PK) profile.ResultsIn buparlisib + AA arm, 25 patients received buparlisib + AA (median age, 67 years; Eastern Cooperative Oncology Group performance status (ECOG PS) of 0/1/2 for 7/17/1 patients, respectively). At 100 mg qd; two patients experienced dose-limiting toxicities (DLTs) (grade 3 hyperglycaemia; grade 2 asthenia), and this was the maximum buparlisib dose explored. Buparlisib + AA showed a 26% lower median area under the curve from time zero to 24°h (AUC_0–24) and 48% lower median maximum serum concentration (Cmax) versus the single-agent buparlisib assessed in first-in-human study. No objective response and few PSA decreases were reported.In dactolisib + AA arm, 18 patients (median age, 71 years; ECOG PS of 0/1 for 6/12 patients, respectively) received dactolisib + AA at the first dose level (200 mg bid). Five patients had 9 DLTs (grades 2&3 stomatitis; grade 3 hyperglycaemia; grades 2& 3 diarrhoea; grades 1& 2 pyrexia, grade 2 vomiting, and grade 2 chills).ConclusionsBased on the assessment of available pharmacokinetics, safety, and efficacy data, no further study is planned for either buparlisib or dactolisib in combination with AA in CRPC.     

子宫内膜癌组织中PCNA、MVD的检测及其意义

背景与目的:子宫内膜癌发病率呈逐年上升趋势,但其确切发病机制及预后因素尚不明确。本实验旨在研究增殖细胞核抗原(proliferating cell nuclear antigen.PCNA)指数、微血管密度microvessel density.MVD雪在子宫内膜癌组织中的表达,并结合肿瘤的手术病理分期、病理分级,进一步判断其价值。方法:采用免疫组织化学SP法,检测62例子宫内膜腺癌、22例正常子宫内膜组织的PCNA指数和MVD,结合肿瘤的临床分期、病理分级,对结果进行统计学分析。结果:子宫内膜癌组织中PCNA指数(54.49±9.29)和MVD(48.97±8.56)较正常子宫内膜明显增高(P<0.05);子宫内膜癌的期别越晚、分化越差,PCNA指数和MVD越高(P<0.05);在子宫内膜癌组织中,PCNA指数与MVD呈正相关。结论:PCNA指数、MVD增高与子宫内膜癌的发展有关;血管生成促进肿瘤细胞增殖。     

平消胶囊联合介入栓塞化疗术(TAE)治疗中晚期肝癌(附56例临床报告)

目的探求治疗中晚期肝癌的有效方法。方法选择56例中晚期肝癌患者随机分两组进行前瞻性对比治疗研究。治疗组31例,用平消胶囊联合介入栓塞化疗（TAE）术,对照组25例单用TAE术。结果治疗组和对照组有效率（CR＋PR）分别为80．64％、68％（P＜0．05）,进展率（PD）分别为0％和8％（P＜0．001）,治疗前后症状改善率分别为80．64％和64％（P＜0．05）,AKP变化也有显著差异。毒副反应治疗组校对照组明显少而轻。结论平消胶囊联合TAE术,治疗中晚期肝癌具有协同作用,疗效明显,值得推广应用。     

Comparison of initial tumor responses to transarterial bland embolization and drug-eluting beads-transarterial chemoembolization in the management of hepatocellular carcinoma: a propensity-score matching analysis

BackgroundTransarterial bland embolization (TABE) is widely used to treat the spontaneous rupture of hepatocellular carcinoma (HCC), and can lead to ischemic necrosis of the tumor. In this study, we used the propensity-score matching (PSM) method to compare the initial responses of treatment-naïve HCC patients to TABE and drug-eluting beads-transarterial chemoembolization (DEB-TACE), and the safety of these treatments.MethodsPatients with treatment-naïve HCC, who had been admitted to 2 medical centers from January 2016 to December 2020, were enrolled as the research subjects. The data of 26 patients treated with TABE for ruptured HCC and 52 patients treated with DEB-TACE for primary HCC were collected according to our inclusion and exclusion criteria, and a PSM analysis was conducted to assess the safety and effectiveness of these two interventional techniques 1 month postoperatively.ResultsIn relation to ruptured HCC, TABE had a hemostatic success rate of 97.0%. Before PSM, the TABE group had a larger maximum tumor diameter (P<0.05), a higher proportion of multiple tumors (P<0.05), a higher proportion of Child-Pugh class B (P<0.05), and a higher proportion of Barcelona Clinic Liver Cancer (BCLC) stage B (P<0.05) than the DEB-TACE group. After PSM, the baseline characteristics of these two groups were well balanced, and there was no significant difference in patients’ initial therapeutic responses and tumor recurrence rates (both P>0.05). The multivariate regression analysis showed that tumor size was an independent predictor of the objective response rate (ORR) [odds ratio (OR): 3.312; 95% CI: 0.152–5.944; P<0.05]. Tumor number and BCLC stage also affected ORR; however, ORR was not significantly correlated with the interventional technique (TABE vs. DEB-TACE; P>0.05). The incidences of post-embolization syndrome (PES) and 48-h hepatotoxicity were significantly lower in the TABE group than the DEB-TACE group (both P<0.05), but there was no significant difference in hepatotoxicity after 1 month (P>0.05).ConclusionsTABE is highly effective at managing hemorrhage from ruptured HCC. The initial therapeutic response of HCC to TABE is similar to that to DEB-TACE; however, TABE is associated with lower hepatotoxicity and fewer adverse effects, which paves the way for subsequent treatments and systemic therapies.