Jin Wei, Han Haiming, Zhou Shulong, Wang Yingchao, Dong Tao, Zhao Cunxin
Department of Gastroenterology, The Yidu Central Hospital of Weifang Weifang 262500, Shandong, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):18954-62. eCollection 2015.
This study is to investigate the effects of brucea javanica oil emulsion (BJOE) combined with transcatheter hepatic arterial chemoembolization (TACE) on primary liver cancer (PLC) and the related mechanisms. Totally 64 PLC patients were divided into the TACE monotherapy and BJOE/TACE combination therapy groups. The short- and long-term efficacies, and the toxicity and tolerability profiles, of these treatments were evaluated. The serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) were detected with ELISA. For the short-term efficacy, the response rate (RR) in the TACE monotherapy and BJOE/TACE combination therapy groups were 50% (16/32) and 78.12% (25/32), respectively. Survival analysis showed that, the combination therapy significantly elevated the 1-, 2-, and 3-year survival rates of PLC patients, compared with the monotherapy. No significant differences were observed in the toxicity and tolerability profiles between these therapies. ELISA showed that, the serum sFas/sFasL levels were significantly increased in PLC patients. At 1 m after the combination therapy, the serum sFas/sFasL levels were significantly higher than before treatment. At 3 m and 6 m after treatment, the serum sFas/sFasL levels were gradually declined. The short- and long-term efficacies of the BJOE/TACE combination therapy for PLC are superior to the TACE monotherapy. The combination therapy could promote liver cancer cell apoptosis by regulating the expression of sFas/sFasL. Serum sFas/sFasL levels might be used as the predictive marker for the disease pathogenesis and prognosis, and the treatment efficacy.
本研究旨在探讨鸦胆子油乳剂(BJOE)联合经肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PLC)的效果及其相关机制。将64例PLC患者分为TACE单药治疗组和BJOE/TACE联合治疗组。评估这些治疗方法的短期和长期疗效以及毒性和耐受性。采用酶联免疫吸附测定法(ELISA)检测血清可溶性Fas(sFas)和可溶性Fas配体(sFasL)水平。短期疗效方面,TACE单药治疗组和BJOE/TACE联合治疗组的有效率(RR)分别为50%(16/32)和78.12%(25/32)。生存分析表明,与单药治疗相比,联合治疗显著提高了PLC患者的1年、2年和3年生存率。这些治疗方法在毒性和耐受性方面未观察到显著差异。ELISA结果显示,PLC患者血清sFas/sFasL水平显著升高。联合治疗后1个月,血清sFas/sFasL水平显著高于治疗前。治疗后3个月和6个月,血清sFas/sFasL水平逐渐下降。BJOE/TACE联合治疗PLC的短期和长期疗效优于TACE单药治疗。联合治疗可通过调节sFas/sFasL的表达促进肝癌细胞凋亡。血清sFas/sFasL水平可能作为疾病发病机制、预后及治疗疗效的预测指标。