CT引导下微波消融术联合仑伐替尼治疗原发性肝癌的疗效

摘要/Abstract

摘要： 目的探讨CT引导下微波消融术(MWA)联合仑伐替尼在原发性肝癌患者中的临床疗效及其对患者生存质量和预后的影响。方法选取2024年1月至2024年12月玉林市红十字会医院收治的96例原发性肝癌患者,随机分为对照组和观察组,各48例。观察组接受CT引导下MWA联合仑伐替尼疗法,对照组只接受MWA。比较两组患者肿瘤大小、肝生化指标、血清肿瘤标志物。治疗3个月后,评估复发情况,并进行为期1年的随访以观察长期生存情况及不良反应发生率。结果治疗后,观察组甲胎蛋白(AFP)、异常凝血酶原-Ⅱ(PIVKA-Ⅱ)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)水平分别为(74.50±33.84)ng/mL、(128.84±47.69)mAU/mL、(93.22±40.83)U/L、(84.62±36.15)U/L和(23.58±3.65)μmol/L,低于对照组的(116.25±46.52)ng/mL、(191.01±42.84)mAU/mL、(145.69±57.60)U/L、(138.96±40.56)U/L和(34.36±4.18)μmol/L(P<0.05)。观察组白蛋白(Alb)水平为(37.63±4.69)g/L高于对照组的(33.75±4.36)g/L(P<0.05)。治疗后4周,观察组总有效率高于对照组(P<0.05)。随访12个月,观察组复发率低于对照组,1年生存率高于对照组(P<0.05)。结论 CT引导下微波消融术联合仑伐替尼在治疗原发性肝癌患者中显示出显著的临床优势。与单独使用MWA的对照组相比,联合治疗不仅有效降低了患者的肿瘤标志物水平,改善肝功能,还提高了总有效率和生存质量。经过12个月的随访,观察组显示出较低的肿瘤复发率及较高的1年生存率,进一步证明了该治疗方案具有长期效果和优越性。因此,MWA联合仑伐替尼可能成为原发性肝癌治疗的一个新的有效选择。

关键词: 微波消融, 仑伐替尼, 原发性肝癌, 生存率, 肝功能

Abstract: Objective To explore the clinical efficacy of CT-guided microwave ablation (MWA) combined with lenvatinib in patients with primary liver cancer (PLC) and its impact on patients′ quality of life and prognosis. Methods A total of 96 patients with PLC who were treated at Yulin Red Cross Hospital from January 2024 to December 2024 were randomly divided into an observation group (48 patients) and a control group (48 patients). The observation group received CT-guided MWA combined with lenvatinib treatment, while the control group received MWA alone. Tumor size, liver function, serum tumor markers were compared between two groups. Recurrence was assessed after 3 months of treatment, and the long-term survival and adverse event rates were observed after a 1-year follow-up. Results After treatment, the levels of alpha-fetoprotein (AFP), prothrombin induced by vitamin K absence-Ⅱ (PIVKA-Ⅱ), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) in the observation group were (74.50±33.84) ng/mL, (128.84±47.69) mAU/mL, (93.22±40.83) U/L, (84.62±36.15) U/L, and (23.58±3.65) μmol/L, respectively, which were lower than control group, which were (116.25±46.52) ng/mL, (191.01±42.84) mAU/mL, (145.69±57.60) U/L, (138.96±40.56) U/L, and (34.36±4.18) μmol/L (P<0.05). The albumin (Alb) level in the observation group was (37.63±4.69) g/L, which was higher than control group, which was (33.75±4.36) g/L (P<0.05). Fourweek post-treatment, the observation group had a higher total effective rate (P<0.05). After 12 months, the recurrence rate was lower, and the 1-year survival rate higher in the observation group (P<0.05). Conclusion CT-guided MWA combined with lenvatinib demonstrates significant clinical advantages in the treatment of PLC. Compared with the control group who received MWA alone, the combined therapy not only effectively reduced tumor marker levels and improved liver function but also increased the total effective rate and quality of life of patients. After 12 months of follow-up, the observation group showed a lower tumor recurrence rate and a higher 1-year survival rate, further proving the long-term effectiveness and superiority of this treatment regimen. Therefore, MWA combined with lenvatinib may become a new and effective option for the treatment of PLC.

Key words: Microwave ablation, Lenvatinib, Primary liver cancer, Survival rate, Liver function

庞成, 莫超艳, 黄昌发, 王友华. CT引导下微波消融术联合仑伐替尼治疗原发性肝癌的疗效[J]. 肝脏, 2026, 31(3): 375-379.

PANG Cheng, MO Chao-yan, HUANG Chang-fa, WANG You-hua. Efficacy of CT-guided microwave ablation combined with lenvatinib in primary liver cancer[J]. Chinese Hepatolgy, 2026, 31(3): 375-379.

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