摘要
目的:探讨贝伐珠单抗注射液联合肝动脉化疗栓塞术(TACE)对中晚期肝细胞癌(HCC)患者肿瘤标志物、血管生成因子和凋亡分子的影响.方法:采用随机数字表法将2021年9月～2023年4月期间我院收治的142例中晚期HCC患者分为对照组(n=71,TACE治疗)和研究组(n=71,贝伐珠单抗注射液联合TACE治疗).对比两组疗效、血清肿瘤标志物[甲胎蛋白(AFP)、癌胚抗原(CEA)、α-L-岩藻糖苷酶(AFU)、糖类抗原19-9(CA19-9)]、血管生成因子指标[肝细胞生长因子(HGF)、血管内皮生长因子(VEGF)、结缔组织生长因子(CTGF)、缺氧诱导因子-1α(HIF-1α)]和凋亡分子[B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关X蛋白基因(Bax)、生存素(Survivin)、C-半胱氨酸-天冬氨酸蛋白酶10(Caspase 10)]变化情况,并观察两组不良反应发生率.结果:研究组的客观缓解率(ORR)、疾病控制率(DCR)明显高于对照组(P＜0.05).治疗6周后,两组AFP、CEA、AFU、CA19-9、HGF、VEGF、CTGF、HIF-1α、Bcl-2、Survivin下降,Bax、Caspase 10升高,且研究组的改善幅度大于对照组(P＜0.05).对照组的不良反应发生率为12.69％,研究组的为19.73％,组间比较无差异(P＞0.05).结论:贝伐珠单抗注射液联合TACE治疗中晚期HCC患者,可有效降低肿瘤标志物水平,减少血管生成,促进HCC癌细胞凋亡.
Abstract
Objective:To investigate the effects of bevacizumab injection combined with transcatheter arterial chemoembolization(TACE)on tumor markers,angiogenic factors and apoptotic molecules in patients with middle to late stage hepatocellular carcinoma(HCC).Methods:Random number table method was used,142 patients with middle to late stage HCC who were admitted to our hospital from September 2021 to April 2023 were divided into control group(n=71,TACE treatment)and study group(n=71,bevacizumab injec-tion combine with TACE treatment).The efficacy,serum tumor markers[alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),α-L-fucosidase(AFU),carbohydrate antigen 19-9(CA19-9)],angiogenesis factors[hepatocyte growth factor(HGF),vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),hypoxia-inducible factor-1α(HIF-1α)]and apoptotic molecules[B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein gene(Bax),survivin(Survivin),C-cysteine-aspartate protease 10(Caspase 10)]were compared between two groups,the incidence of adverse reactions in two groups was observed.Results:The objective response rate(ORR)and disease control rate(DCR)in study group were significantly higher than those in control group(P＜0.05).6 weeks after treat-ment,AFP,CEA,AFU,CA19-9,HGF,VEGF,CTGF,HIF-1α,Bcl-2 and Survivin in two groups decreased,Bax and Caspase 10 in two groups increased,and the improvement in the study group was greater than that in the control group(P＜0.05).The incidence of adverse reactions in the control group was 12.69％,while in the study group was 19.73％,there was no significant difference between the groups(P＞0.05).Conclusion:The combination of bevacizumab injection and TACE in the treatment of advanced HCC patients can effectively reduce tumor marker levels,reduce angiogenesis,and promote HCC cancer cell apoptosis.
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