TACE联合甲磺酸仑伐替尼治疗中晚期原发性肝癌的效果及安全性

摘要/Abstract

摘要： 目的分析经动脉化疗栓塞术(TACE)与TACE联合甲磺酸仑伐替尼治疗中晚期原发性肝癌(PLC)的效果及安全性。方法选取宝鸡市中心医院收治的125例中晚期PLC患者(2020年2月—2024年4月),按治疗方法分为2组,对照组61例采取TACE治疗,观察组64例采取TACE加用甲磺酸仑伐替尼治疗,比较2组疗效。结果观察组DCR率、ORR率较对照组更高[84.38%(54/64) vs. 65.57%(40/61),62.50%(40/64) vs. 31.15%(19/61);χ²=5.920、12.319,均P<0.05]。治疗3周,观察组AST、ALT、TBil低于对照组[(35.62±6.14)U/L vs. (43.52±7.63)U/L、(62.01±4.28)U/L vs. (67.17±5.32)U/L、(20.02±3.47)μmol/L vs. (21.82±3.08)μmol/L;P<0.05)]。治疗3周,观察组CD3⁺、CD4⁺高于对照组[(66.22±8.19)/μL vs. (62.04±7.60)/μL、(33.69±3.74)/μL vs. (30.05±3.47)/μL)],CD8⁺低于对照组[(26.23±2.84)/μL vs. (29.96±3.17))/μL;P<0.05)]。治疗3周,观察组AFP、CEA低于对照组[(79.62±6.47)ng/mL vs. (150.39±10.46)ng/mL、(13.66±2.34)U/mL vs. (14.85±2.47)U/mL],CA199高于对照组[(31.04±5.07)ng/mL vs. (28.03±4.92)ng/mL;P<0.05]。观察组发热发生率低于对照组[3.13%(2/64) vs. 13.11%(8/61);χ²=4.235,P=0.040]。随访1年,观察组生存率高于对照组[92.19%(59/64) vs. 83.61%(51/61)](χ²=0.285,P=0.594)。结论中晚期PLC患者采取TACE联合甲磺酸仑伐替尼治疗效果显著,可显著改善免疫功能和肝功能,有效降低肿瘤标志物水平,病死率较低。

关键词: 经动脉化疗栓塞术, 甲磺酸仑伐替尼, 中晚期, 原发性肝癌

Abstract: Objective To analyze the efficacy of transarterial chemoembolization (TACE) and TACE combined with lenvatinib mesylate in the treatment of advanced primary liver cancer (PLC) and its impact on safety. Methods A total of 125 patients with advanced PLC admitted to Baoji Central Hospital (February 2020-April 2024) were selected and divided into two groups according to the treatment methods. 61 cases in the control group were treated with TACE, and 64 cases in the observation group were treated with lenvatinib mesylate in addition. The therapeutic effects of the two groups were compared. Results The DCR rate of the observation group was 84.38% (54/64), and the ORR rate was 62.50% (40/64), which were 65.57% (40/61) /31.15% (19/61) higher than those of the control group (χ² values=5.920, 12.319; all P values＜0.05). Three weeks of treatment The AST level (35.62±6.14) U/L, ALT level (62.01±4.28) U/L, and TBil level (20.02±3.47) μmol/L in the observation group were lower than those in the control group [43.52±7.63) U/L, (67.17±5.32) U/L, (21.82±3.08) μmol/L] (P<0.05). After 3 weeks of treatment, the levels of CD3⁺ (66.22±8.19)/μL and CD4⁺ (33.69±3.74)/μL in the observation group were higher than those in the control group (62.04±7.60)/μL and (30.05±3.47)/μL, while the level of CD8⁺ (26.23±2.84)/μL was lower than that in the control group (29.96±3.17)/μL (P<0.05). After 3 weeks of treatment, the AFP level (79.62±6.47) ng/mL and CEA level (13.66±2.34) U/mL in the observation group were lower than those in the control group [(150.39±10.46) ng/mL and (14.85±2.47) U/mL]. The level of CA199 (31.04±5.07) ng/mL was higher than that of the control group (28.03±4.92) ng/mL (P<0.05). The incidence of fever in the observation group was 3.13% (2/64), which was lower than 13.11% (8/61) in the control group (χ² value=4.235, P value=0.040). Patients were followed up for one year. The survival rate of the observation group was 92.19% (59/64), which was higher than that of the control group at 83.61% (51/61). χ²=0.285, P=0.594. Conclusion The treatment of advanced PLC patients with TACE combined with lenvatinib mesylate has a significant effect. It can significantly improve immune function and liver function, effectively reduce tumor markers, and has a low mortality rate.

Key words: Transarterial chemoembolization Lenvatinib mesylate Middle and late stages, Primary liver cancer

殷宏玲, 袁玥, 张海利. TACE联合甲磺酸仑伐替尼治疗中晚期原发性肝癌的效果及安全性[J]. 肝脏, 2026, 31(3): 390-393.

YIN Hong-ling, YUAN Yue, ZHANG Hai-li. The efficacy of TACE and TACE in combination with lenvatinib mesylate in the treatment of intermediate and advanced primary liver cancer and its impact on safety[J]. Chinese Hepatolgy, 2026, 31(3): 390-393.

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