仑伐替尼联合TACE对不可切除肝细胞癌患者肿瘤标志物、凋亡分子和血清ST6GAL1、ANG-2、HGF的影响

摘要 目的：探讨仑伐替尼联合肝动脉化疗栓塞术（TACE）对不可切除肝细胞癌患者肿瘤标志物、凋亡分子和血清唾液酸转移酶1（ST6Gal1）、血管生成素-2（ANG-2）、肝细胞生长因子（HGF）的影响。方法：采用随机数字表法将四川绵阳四0四医院2020年3月~2022年12月期间收治的114例不可切除肝细胞癌患者分为对照组（n=57，TACE治疗）和研究组（n=57，仑伐替尼联合TACE治疗）。对比两组疗效、肿瘤标志物[甲胎蛋白（AFP）、糖类抗原199（CA199）、癌胚抗原（CEA）]、血清凋亡分子[B淋巴细胞瘤-2相关X蛋白（Bax）、B淋巴细胞瘤-2基因（Bcl-2）、存活素（Survivin）、半胱氨酸天冬氨酸蛋白酶-4（Caspase-4）]和血清ST6Gal1、ANG-2、HGF水平，并观察两组治疗期间不良反应发生情况。结果：与对照组相比，研究组的临床总有效率更高（P<0.05）。与对照组相比，研究组治疗后AFP、CA199、CEA水平更低（P<0.05）。与对照组相比，研究组治疗后Bcl-2、Survivin水平更低，Bax、Caspase-4水平更高（P<0.05）。与对照组相比，研究组治疗后ST6Gal1、ANG-2、HGF水平更低（P<0.05）。两组不良反应总发生率组间对比未见差异（P>0.05）。结论：仑伐替尼联合TACE用于不可切除肝细胞癌患者，可提高临床治疗效果，调节肿瘤标志物、凋亡分子和血清ST6Gal1、ANG-2、HGF水平，安全性较好。

Effect of Lenvatinib Combined with TACE on Tumor Markers, Apoptotic Molecules and Serum ST6GAL1, ANG-2 and HGF in Patients with Unresectable Hepatocellular Carcinoma

ABSTRACT Objective: To investigate the effects of lenvatinib combined with transcatheter arterial chemoembolization (TACE) on tumor markers, apoptotic molecules, serum sialic acid transferase 1 (ST6Gal1), angiopoietin-2 (ANG-2) and hepatocyte growth factor (HGF) in patients with unresectable hepatocellular carcinoma. Methods: 114 patients with unresectable hepatocellular carcinoma who were admitted to Sichuan Mianyang 404 Hospital from March 2020 to December 2022 were divided into control group (n=57, TACE treatment) and study group (n=57, lenvatinib combine with TACE treatment) by random number table method.The efficacy, tumor markers [alpha-fetoprotein (AFP), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA)], serum apoptotic molecules [B-cell lymphoma-2-associated X protein (Bax), B-cell lymphoma-2 gene (Bcl-2), survivin (Survivin), cysteine aspartic protease-4 (Caspase-4)] and serum ST6Gal1, ANG-2, HGF levels were compared between two groups, and the incidence of adverse reactions during treatment was observed. Results: Compared with control group, the total clinical effective rate in study group was higher(P<0.05). Compared with control group, the levels of AFP, CA199 and CEA in study group were lower after treatment (P<0.05). Compared with control group, the levels of Bcl-2 and Survivin in study group were lower after treatment, and the levels of Bax and Caspase-4 were higher(P<0.05). Compared with control group, the levels of ST6Gal1, ANG-2 and HGF in study group were lower after treatment(P<0.05). There was no difference in the total incidence of adverse reactions between two groups (P>0.05). Conclusion: Lenvatinib combined with TACE for patients with unresectable hepatocellular carcinoma, which can improve the clinical treatment effect, regulate the levels of tumor markers, apoptotic molecules and serum ST6Gal1, ANG-2 and HGF, with good safety.