二甲双胍联合经肝动脉化疗栓塞术治疗中晚期肝癌的疗效观察

摘要/Abstract

摘要： 目的比较二甲双胍联合经肝动脉化疗栓塞术(Transcatheter arterial chemoembolization TACE)与单纯TACE在中晚期肝癌的疗效。方法将40例中晚期肝癌患者随机分为观察组与对照组,每组各20例。观察组于TACE术后第2天开始加服二甲双胍片, 对照组TACE后不用任何抗肿瘤药物。比较两组患者的客观疗效、生存率、肝功能指标及生存质量的变化。结果 TACE后6个月及12个月,观察组缓解率较对照组高(P<0.05)。随访两组生存率,行TACE 12个月以后,观察组生存率较对照组高 (P<0.05)。两组肝功能指标在TACE后第1天,均较TACE前升高(P<0.05),1个月后,则较TACE前下降(P<0.05);6个月后,观察组肝功能指标较TACE前下降(P<0.05),而对照组无下降(P>0.05);两组间比较,6个月后,观察组肝功能指标较对照组好(P<0.05)。生存质量在TACE后6个月及12个月,观察组较TACE前有显著提高,而对照组则较TACE前显著下降(P均<0.05),观察组与对照组组间比较,发现TACE后6个月及12个月,观察组生存质量优于对照组(P均<0.05)。结论中晚期肝癌患者行TACE治疗后, 加用二甲双胍能提高患者的远期疗效, 延长生存时间及改善生存质量,减少化疗不良反应。

曾炼坤,曾书琴,蒋婵,刘雪芳,邱友燕,夏碧文,沈立平. 二甲双胍联合经肝动脉化疗栓塞术治疗中晚期肝癌的疗效观察[J]. 肝脏, 2017, 22(5): 435-438.

参考文献 21

[1]	Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 2010, 127: 2893-2917.
[2]	Zhang JW,Feng XY,Liu HQ,et al.CT volume measurement for prognostic evaluation of unresectable hepatocellular carcinoma after TACE. World J Gastroenterol,2010,16: 2038-2045.
[3]	Liang SN, Liu LL, Su HY, et al. Analysis of severe complications after transcatheter arterial chemoembolization for primary hepatocellular carcinoma. Zhonghua Zhong Liu Za Zhi,2008,30:790-792.
[4]	Eguchi S, Matsumoto S, Hamasaki K, et al. Re-evaluation of lipiodolized transarterial chemoembolization therapy for intrahepatic recurrence of hepatocellular carcinoma after curative liver resection. J Hepatobiliary Pancreat Surg, 2008,15: 627-633.
[5]	Ueda H, Tanaka H, Kida Y, et al. Adjuvant chemotherapy with tegafur/uracil administration after transcatheter arterial chemoembolization for advanced hepatocellular carcinoma. Oncol Rep, 2008, 19:1355-1361.
[6]	Kothary N, Weintraub JL, Susman J, et al. Transarterial chemoembolization for primary hepatocellular carcinoma in paients at high risk. J Vasc Interv Radiol, 2007, 18: 1517-1526.
[7]	Liu B, Fan Z, Edgerton SM, et al. Metformin induces unique biological and molecular responses in triple negative breast cancer cells. Cell Cycle, 2009, 8: 2031-2040.
[8]	Rattan R, Giri S, Hartmann LC, et al. Metformin attenuates ovarian cancer cell growth in an AMP-kinase dispensable manner. J Cell Mol Med, 2011, 15: 166-178.
[9]	Tan BK, Adya R, Chen J, et al. Metformin treatment exerts antiinvasive and antimetastatic effects in human endometrial carcinoma cells. J Clin Endocrinol Metab, 2011, 96: 808-816.
[10]	Kisfalvi K, Eibl G, Sinnett-Smith J, et al. Metformin disrupts crosstalk between G protein-coupled receptor and insulin receptor signaling systems and inhibits pancreatic cancer growth. Cancer Res, 2009, 69: 6539-6545.
[11]	Zhang ZJ, Zheng ZJ, Kan H, et al. Reduced risk of colorectal cancer with metformin therapy in patients with type 2 diabetes: a meta-analysis. Diabetes Care, 2011, 34: 2323-2328.
[12]	Jung JW, Park SB, Lee SJ, et al. Metformin represses self-renewal of the human breast carcinoma stem cells via inhibition of estrogen receptor-mediated OCT4 expression. PLoS One, 2011, 6:e28068.
[13]	Wang P, Kang D, Cao W, et al. Diabetes mellitus and risk of hepatocellular carcinoma: a systematic review and meta-analysis.Diabetes Metab Res Rev, 2012, 28: 109-122.
[14]	Ha BY, Ahmed A, Sze DY, et al. Long-term survival of patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoinfusion. Aliment Pharmacol Ther, 2007, 26: 839-846.
[15]	凌昌全,李琦.中药经肝动脉介入治疗原发性肝癌的现状、存在问题及前景.中医杂志,2002,43:69-71
[16]	Cheng J, Huang T, Li Y, et al. AMP-activated protein kinase suppresses the in vitro and in vivo proliferation of hepatocellular carcinoma. PLoS One, 2014, 9: e93256.
[17]	Meng S, Cao J, He Q,et al. Metformin activates AMP-activated protein kinase by promoting formation of the αβγ heterotrimeric complex. J Biol Chem, 2015, 290: 3793-3802.
[18]	Li W, Saud SM, Young MR, et al. Targeting AMPK for cancer prevention and treatment. Oncotarget, 2015, 6: 7365-7378.
[19]	Storozhuk Y, Hopmans SN, Sanli T, et al. Metformin inhibits growth and enhances radiation response of non-small cell lung cancer (NSCLC) through ATM and AMPK. Br J Cancer, 2013, 108: 2021-2032.
[20]	Han G, Gong H, Wang Y, et al. AMPK/mTOR-mediated inhibition of survivin partly contributes to metformin-induced apoptosis in human gastric cancer cell. Cancer Biol Ther, 2015, 16: 77-87.
[21]	刘立鑫,邹浩,魏东,等. 二甲双胍对肝癌细胞HCCLM3生物学行为的影响. 昆明医科大学学报,2015,36:33-37.