Wang Yu, Xuan Zhidong, Zheng Xue, Han Ruoling, Zhou Li, Liu Haixia, Liu Yongrong
Department of Ultrasound (III), Cangzhou Central Hospital, Cangzhou 061000, P.R.China.
J BUON. 2019 Nov-Dec;24(6):2394-2401.
To evaluate the effect of transcatheter arterial chemoembolization (TACE) under the guidance of contrast-enhanced ultrasound (CEUS) in patients with advanced hepatocellular carcinoma (HCC).
One hundred and sixty patients with HCC admitted to Cangzhou Central Hospital from April 2015 to April 2017 were enrolled. The clinical data were retrospectively analyzed. Seventy-five patients who underwent TACE according to CEUS results were selected as the observation group. The remaining 85 cases that underwent digital subtraction augiography (DSA) angiography-guided TACE were selected as the control group and were intravenously infused with 15 mg of Endostar+500 mL of normal saline once a day for 3 consecutive days (Endostar 30 mg was reperfused during the operation). Both groups were re-contrasted at 1 month (T2) and 3 months (T3) to determine whether TACE was performed again. The numbers of TACEs re-performed were recorded. Color Doppler energy imaging was used to observe the neovascularization of the tumor. The changes of serum vascular endothelial growth factor (VEGF) and CRP levels were detected by enzyme-linked immunosorbent assay (ELISA).
There were significant differences in the number of TACEs re-performed between the observation group and the control group (p<0.05). The serum VEGF level in the observation group was always lower than that in the control group (p<0.05). CRP levels in the control group showed an upward trend. The serum CRP level in the control group was significantly higher compared to the observation group at T3. The number of grades 0 and 1 neovascularization in the control group was significantly lower than in the observation group. The neovascularization rate of the observation group was significantly higher than the control group; the tumor effective rate of the observation group was not different from that of the control group, but the disease control rate was higher than in the control group.
CEUS-guided TACE treatment of HCC can effectively inhibit tumor angiogenesis, control tumor progression, and prolong the survival of patients, which is conducive to the prognosis of patients.
评估超声造影(CEUS)引导下经动脉化疗栓塞术(TACE)对晚期肝细胞癌(HCC)患者的疗效。
选取2015年4月至2017年4月在沧州市中心医院收治的160例HCC患者,对其临床资料进行回顾性分析。根据CEUS结果接受TACE治疗的75例患者作为观察组。其余85例行数字减影血管造影(DSA)引导下TACE的患者作为对照组,每天静脉输注15mg恩度+500mL生理盐水,连续3天(术中再灌注30mg恩度)。两组分别于1个月(T2)和3个月(T3)再次造影,确定是否再次行TACE,并记录再次行TACE的次数。采用彩色多普勒能量成像观察肿瘤新生血管情况。采用酶联免疫吸附测定(ELISA)法检测血清血管内皮生长因子(VEGF)和CRP水平的变化。
观察组与对照组再次行TACE的次数差异有统计学意义(p<0.05)。观察组血清VEGF水平始终低于对照组(p<0.05)。对照组CRP水平呈上升趋势,T3时对照组血清CRP水平显著高于观察组。对照组0级和1级新生血管数量显著低于观察组。观察组新生血管化率显著高于对照组;观察组肿瘤有效率与对照组无差异,但疾病控制率高于对照组。
CEUS引导下TACE治疗HCC能有效抑制肿瘤血管生成,控制肿瘤进展,延长患者生存期,有利于患者预后。