腹腔镜下射频消融术在肝癌患者中的临床应用价值及其对血清血管内皮生长因子和基质金属蛋白酶-2的影响*

目的探讨腹腔镜下射频消融术(LRFA)在肝癌患者中的临床应用价值及其对血清血管内皮生长因子(VEGF)和基质金属蛋白酶-2(MMP-2)的影响。方法收集2012年1月-2013年12月该院收治的晚期原发性肝癌患者120例,将患者随机分为LRFA组和对照组。LRFA组患者采用LRFA治疗后,继续采用FOLFOX4方案化疗;对照组仅采用PIAF方案化疗。主要观察指标为健康相关生存质量(HRQL)、实体瘤疗效评价(RECIST)等级、无进展生存期和2年死亡率;次要观察指标为血清VEGF和MMP-2水平。结果与对照组相比,LRFA组患者病情进展率明显降低(28.33%vs 50.00%,P=0.015);无进展生存期明显延长(500 d vs 380 d,P=0.013);临床干预后6个月时HRQL明显增高(80.33±5.84)vs(65.87±9.59),P=0.000];临床干预后7、14和28天以及6个月时VEGF明显降低(P值均为0.000);临床干预后14和28天以及6个月时MMP-2明显降低(P值分别为0.003、0.001和0.000)。结论 LRFA明显改善了肝癌患者临床预后,并显著降低患者VEGF、MMP-2水平。

Clinical values of laparoscopic radiofrequency ablation in liver cancer and its impacts on serumal VEGF and MMP-2*

Objective To investigate the clinical values of laparoscopic radiofrequency ablation in liver cancer and its impacts on serumal VEGF and MMP-2. Method From Jan, 2012 to Dec, 2013, a series of patients with primary liver cancer were studied, patients were randomly signed into LAFA group or control group. During the study period, LRFA group were treated with laparoscopic radiofrequency ablation combined with FOLFOX4 chemotherapy while patients in control group were treated with PIAF chemotherapy only. The primary outcomes were the Health related quality of life score (HRQL), the degree of solid tumors classification, progression-free survival duration and 2-year mortality. The secondly primary outcomes included the level of serumal VEGF and MMP-2. Result When compared with the control group, patients in LRFA group got a significantly lower rate of disease progression (28.33 % vs 50.00 %, P = 0.015); a longer progression-free survival duration (500 vs 380 d, P = 0.013); a higher HRQL (80.33 ± 5.84 vs 65.87 ± 9.59, P = 0.000); a significantly lower level of VEGF at 7 days, 14 days, 28 days and 6 months after the clinical intervention were started (all P values were 0.000); a significantly lower level of MMP-2 at 14 days, 28 days and 6 months after the clinical intervention were started (the P values were 0.003, 0.001 and 0.000). Conclusion Laparoscopic radiofrequency ablation improved the long-term clinical outcomes and decreased the serumal level of VEGF and MMP-2.