TACE联合索拉非尼对原发性肝癌的疗效及其预后相关影响因素
摘要
目的探讨TACE联合索拉非尼对原发性肝癌的疗效及其预后相关影响因素分析。方法选取我科收治的收治的120例中晚期PLC患者,根据治疗方式的不同,分为研究组及对照组两组(各60例),其中研究组(采用TACE联合索拉非尼治疗)和对照组(采用TACE治疗),比较2组患者的临床疗效等差异。结果研究组患者治疗后的临床总有效率(73.33%)显著高于对照组患者(48.33%)患者(P<0.05);研究组患者皮肤反应的发生率显著高于对照组(P<0.05),而两组患者在恶心呕吐、腹痛腹泻、肝功能异常及白细胞下降方面的不良反应发生率比较,均无统计学差异(P>0.05); Child pugh分级、甲胎蛋白、肿瘤血管侵犯、口服索拉非尼、中性粒细胞与淋巴细胞比值、肿瘤平均直径及谷丙转氨酶均对中晚期PLC患者的总生存率有影响(均P<0.05);经Logistic回归分析,发现术前AFP>400 ng/mL、术前中性粒细胞与淋巴细胞比值≥1.77及肿瘤平均直径>5 cm是中晚期PLC患者治疗后影响预后效果的危险因素(均P<0.05)。结论 TACE联合索拉非尼对原发性肝癌的疗效显著且安全,同时发现术前AFP>400 ng/mL、肿瘤平均直径>5 cm及术前中性粒细胞与淋巴细胞比值≥1.77是中晚期PLC患者治疗后影响预后效果的危险因素,因此在今后的临床工作中,应重点加强对高危患者的监控。
引文
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[3] Eisenhauer EA,Therasse P,Bogaerts J,et al.New response evaluation criteria in solidtumours:revised RECIST guideline(version 1.1).Eur J Cancer,2009,45:228-247.
[4] 丁海斌.中药联合TACE对原发性肝癌的疗效及对其肝功能的影响研究.实用癌症杂志,2018,33:787-789.
[5] Liu L,Cao Y,Chen C,et al.Sorafenib blocks the RAF/MEK/ERK pathway,inhibits tumor angiogenesis,and induces tumor cell apoptosis in hepatocellular carcinoma model PLC/PRF/5.Cancer Res,2006,66:11851-11858 .
[6] 李金鹏,胡善亮,陈华,等.NLR对肝癌TACE 患者预后影响的分析.中华肿瘤防治杂志,2013,20:522-25.
[7] Xiao Q,Zhang B,Deng X,et al.The preoperative neutrophil-to-lymphocyte ratio is a novel immune parameter for the prognosis of esophageal basaloid squamous cell carcinoma.PLoS One,2016,11:e0168299.
[8] 朱亮,徐阿曼.中性粒细胞与恶性肿瘤关系的研究进展.新医学,2012,427-429.
[9] Kavunja HW,Lang S,Sungsuwan S,et al.Delivery of foreign cytotoxic T lymphocyte epitopes to tumor tissues for effective antitumor immunotherapy against pre-established solid tumors in mice .Cancer Immunol Immunother,2017,66:451-460.