手术切除与介入栓塞治疗肝癌术后复发患者的临床对比研究

目的:比较手术切除与介入栓塞治疗肝癌术后复发患者的临床疗效。方法:选择2010年6月到2011年6月本院收治的92例肝癌手术切除术后复发患者,按随机数字表法分为手术切除组和介入栓塞组,各46例。手术切除组患者给予再次切除治疗,介入栓塞组患者给予介入栓塞治疗。记录并比较两组患者治疗后1年、3年及5年的生存率。检测并比较两组患者治疗前后血清肝纤维化指标,包括血清透明质酸(HA)、层黏蛋白(LN)、人Ⅲ型前胶原(HPC-Ⅲ)及IV型胶原(IV-C)水平。检测并比较两组患者治疗前后血清白细胞(WBC)、甲胎蛋白(AFP)及癌胚抗原(CEA)水平。结果:手术切除组患者治疗后1年、3年、5年的生存率均明显高于介入栓塞组,差异均具有统计学意义(P0.05)。治疗后,介入栓塞组血清HA、LN、HPC-Ⅲ及IV-C明显高于治疗前,且均明显高于手术切除组,差异均具有统计学意义(P0.05)。两组患者治疗后血清WBC、AFP及CEA水平均明显低于治疗前,且手术切除组患者血清WBC明显高于介入栓塞组,而血清AFP、CEA水平明显低于介入栓塞组,差异均具有统计学意义(P0.05)。结论:手术切除治疗肝癌术后复发能够明显提高患者生存率,降低肝纤维化程度,改善血清AFP及CEA水平,值得在临床上推广应用。

Effect of Surgical Resection and Interventional Embolization on Patients with Recurrent Liver Cancer

ABSTRACT Objective: To study the effect of surgical resection and interventional embolization on patients with recurrent liver cancer. Methods: A total of 92 patients with recurrent liver cancer in our hospital from June 2010 to June 2011 were enrolled in this study. The subjects were divided into the surgical resection group (n=46) and the interventional embolization group (n=46) according to the random number table method. The surgical resection group were treated with surgical resection once again, the interventional embolization group were treated with interventional embolization. The survival rates of the two groups at 1 year, 3 years and 5 years after treatment were recorded and compared. The serum hyaluronic acid (HA), laminin (LN), human procollagen type-III (HPC-III), and type IV collagen (IV-C) of the two groups before and after treatment were compared. The serum white blood cell (WBC), alpha fetal protein (AFP) and carcino embryonic antigen (CEA) of the two groups before and after treatment were compared. Results: The survival rates of 1 year, 3 years and 5 years after treatment of the surgical resection group were significantly higher than that of the interventional embolization group (P<0.05). After treatment, the serum HA, LN, HPC-III and IV-C of the interventional embolization group were significantly higher than before treatment (P<0.05), and that of the interventional embolization group were significantly higher than the surgical resection group (P<0.05). The serum WBC, AFP and CEA of the two groups after treatment were significantly lower than before treatment (P<0.05), and the serum WBC of the surgical resection group was significantly higher than the interventional embolization group, the serum AFP and CEA was significantly lower than the interventional embolization group (P<0.05). Conclusion: Surgical resection can signifi- cantly improve the survival rates of patients with recurrent liver cancer,reduce the degree of liver fibrosis, improve the serum levels of WBC, AFP and CEA, and it was worthy clinical application.