经皮穿刺瘤内注入乳剂治疗肝癌TACE术后复发的疗效观察

目的 观察经皮穿刺瘤内注入乳剂治疗肝癌肝动脉化疗栓塞术(TACE)术后复发的临床疗效.方法 选取2010年1月至2015年12月海南省人民医院放射介入科收治的120例TACE术后复发患者为研究对象,按随机数表法分为对照组(TACE重复治疗组)60例和观察组(经皮穿刺瘤内注入乳剂治疗组)60例,比较两组中不同分期患者的临床总有效率、不同时间的复发率、治疗前后的血清复发相关指标血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP)及其他复发相关指标].结果 观察组中Ⅱ期及Ⅲ期患者的临床总有效率分别为95.00%和80.00%,高于对照组的77.50%和45.00%,不同时间的复发率均低于对照组,治疗后的血清复发相关指标(VEGF、MMP及其他复发相关指标)均显著低于对照组,差异均有统计学意义(P<0.05),且观察组患者治疗后的不良反应较轻.结论 经皮穿刺瘤内注入乳剂治疗肝癌TACE术后复发及肿瘤复发相关指标的控制效果较好,具有很好的应用价值.

Effect of percutaneous intratumoral injection of emulsion in the patients with postoperative recurrence of hepatocellular carcinoma after transcatheter arterial chemoembolization

Objective To observe and study the clinical effect by percutaneous intratumoral injection of emul-sion in the patients with postoperative recurrence of hepatocellular carcinoma after transcatheter arterial chemoemboliza-tion (TACE). Methods One hundred and twenty patients with postoperative recurrence of hepatocellular carcinoma af-ter TACE in our hospital from January 2010 to December 2015 were selected as the research objects, which were ran-domly divided into control group (treated by TACE repeatedly, 60 cases) and observation group (treated by percutane-ous intratumoral injection of emulsion, 60 cases) according to the digital table method. Then the total effective rates of different stages, recurrence rates at different time, serum recurrence related indexes (vascular endothelial growth factor VEGF], matrix metalloproteinase MMP] and other recurrence related indexes) before and after the treatment of two groups were respectively analyzed and compared. Results The total effective rates of observation group with stageⅡand stageⅢwere 95.00%and 80.00%, which were higher than 77.50%and 45.00%of control group, and the recur-rence rates at different time were all lower than those of control group. The serum recurrence-related indexes (VEGF, MMP and other recurrence-related indexes) after the treatment were all significantly lower than those of control group (P<0.05), and adverse reactions in the observation group after the treatment were less than those of the control group. Conclusion Percutaneous intratumoral injection of emulsion results in good effect in controlling postoperative recur-rence and tumor recurrence-related indexes of patients with hepatocellular carcinoma after TACE.