A clinical controlled study on RFA combined with hyperthermic perfusion TACE in the treatment of primary hepatocellular carcinoma

Abstract

Abstract: Objective To investigate the efficacy of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma (HCC). Methods Patients with HCC were randomly divided into observation group (treated with RFA combined with hyperthermic perfusion TACE) and control group (treated with RFA combined with conventional TACE). The serum levels of liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), tumor markers alpha fetoprotein (AFP), carbohydrate antigen 199 (CA199), angiogenesis factor hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), apoptosis molecules soluble factor associated suicide (sFas), soluble Fas ligand (sFasL) were detected before and 3 days after the operation, respectively. Results The serum levels of ALT, AST, GGT, sFas and sFasL increased, while the serum levels of AFP, CA199, HIF-1α, VEGF and bFGF decreased in both groups after operation (P<0.05). The serum levels of ALT (64.49 ± 12.72) U/L, AST (70.39 ± 11.38) U/L, GGT (128.69 ± 21.28) U/L of the observation group were not significantly different from those of the control goup, which the serum levels of ALT (66.12 ± 13.27) U/L, AST (71.12 ± 10.93) U/L, GGT (126.78 ± 25.82) U/L, (P>0.05). The serum levels of AFP (83.12 ± 13.82) ng/mL, CA199 (41.29 ± 8.14) U/L, HIF-1α (313.32 ± 62.39) pg/mL, VEGF (201.25 ± 42.94) pg/mL, bFGF (4.58 ± 0.72) pg/mL of the observation group were significantly lower than those of the control group, which the serum levels of AFP (113.28 ± 19.48) ng/mL, CA199 (58.35 ± 9.35) U/L, HIF-1α (394.58 ± 77.24) pg/mL, VEGF (262.44 ± 51.38) pg/mL, bFGF (6.51 ± 0.84) pg/mL. The serum levels of sFas (59.19 ± 9.44) ng/mL and sFasL (73.12 ± 12.57) ng/mL in observation group were higher than those in control group, which the serum levels of sFas (40.27 ± 8.15) ng/mL and sFasL (50.38 ± 9.24) ng/mL, (P<0.05). Conclusion The killing effect on tumor cells of RFA combined with hyperthermic perfusion TACE is better than that of RFA combined with conventional TACE in the treatment for HCC. The molecular mechanisms are inhibiting angiogenesis and promoting apoptosis.

Key words: Primary hepatocellular carcinoma, Radiofrequency ablation, Hyperthermic perfusion transarterial chemoembolization, Angiogenesis, Apoptosis

JIANG Fu-qiang, LU Wei, YANG Jian, YANG Chao, DU Peng. A clinical controlled study on RFA combined with hyperthermic perfusion TACE in the treatment of primary hepatocellular carcinoma[J]. Chinese Hepatolgy, 2021, 26(10): 1087-1090.

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