肝细胞癌中传统经导管肝动脉化疗栓塞术与载药微球经导管肝动脉化疗栓塞术后肝损伤及炎症反应的比较

Comparison of liver injury and inflammatory response following conventional and drug-eluting bead transcatheter chemoembolization in hepatocellular carcinoma.

作者信息

You Ran, Leng Bin, Wang Chendong, Yu Zeyu, Diao Lingfeng, Lu Ya, Xu Qingyu, Yin Guowen

机构信息

Department of Interventional Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, No. 42 Baiziting, Xuanwu District, Nanjing, 210009, China.

出版信息

Discov Oncol. 2025 Apr 10;16(1):504. doi: 10.1007/s12672-025-02286-9.

DOI:10.1007/s12672-025-02286-9

PMID:40208482

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11985740/

Abstract

OBJECTIVE

This study aimed to compare the extent of liver injury and the inflammatory response in patients with hepatocellular carcinoma (HCC) following conventional transarterial chemoembolization (cTACE) and drug-eluting bead transarterial chemoembolization (DEB-TACE).

METHODS

Clinical data from October 2018 to October 2019 were prospectively collected to establish a database. The baseline clinical and demographic characteristics of patients in the two groups were matched using propensity score matching (PSM). Serum levels of hepatic function indicators and inflammatory cytokines were evaluated before treatment and five days post-treatment.

RESULTS

A total of 134 participants were included in the analysis. Following 1:1 PSM, 43 patients remained in each group, with no significant differences observed in baseline characteristics. The median absolute concentration of aspartate aminotransferase (AST) was significantly lower in the DEB-TACE group five days after treatment. Among 18 patients who experienced idiosyncratic drug-induced liver injury, the DEB-TACE group exhibited a significantly lower proportion of cases. The alanine aminotransferase/alkaline phosphatase (ALT/ALP) ratio was notably higher in the cTACE group, while cholestatic-type liver injuries were predominant in the DEB-TACE group. Levels of MCP-1, IL-6, and IL-1β were lower in the DEB-TACE group five days post-treatment. Additionally, MCP-1 levels were significantly correlated with ALT levels and the type of liver injury. Similarly, IL-6 levels showed significant correlations with ALT, AST, and the type of liver injury.

CONCLUSIONS

DEB-TACE was associated with reduced acute liver injury, characterized primarily by cholestatic injury, and a milder inflammatory response compared to cTACE. Post-treatment levels of MCP-1 and IL-6 levels were correlated with aminotransferase levels and the type of liver injury.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR-1800017781. Register URL link: https://www.chictr.org.cn/showproj.html?proj=30041 . Register date: 2018-8-14.

摘要

目的

本研究旨在比较肝细胞癌（HCC）患者在接受传统经动脉化疗栓塞术（cTACE）和载药微球经动脉化疗栓塞术（DEB-TACE）后肝损伤程度和炎症反应情况。

方法

前瞻性收集2018年10月至2019年10月的临床数据以建立数据库。使用倾向得分匹配法（PSM）对两组患者的基线临床和人口统计学特征进行匹配。在治疗前及治疗后五天评估血清肝功能指标和炎症细胞因子水平。

结果

共有134名参与者纳入分析。经过1:1 PSM后，每组各有43例患者，基线特征无显著差异。治疗后五天，DEB-TACE组天冬氨酸转氨酶（AST）的中位绝对浓度显著更低。在18例发生特异质性药物性肝损伤的患者中，DEB-TACE组的病例比例显著更低。cTACE组丙氨酸转氨酶/碱性磷酸酶（ALT/ALP）比值明显更高，而DEB-TACE组以胆汁淤积型肝损伤为主。治疗后五天，DEB-TACE组的MCP-1、IL-6和IL-1β水平更低。此外，MCP-1水平与ALT水平及肝损伤类型显著相关。同样，IL-6水平与ALT、AST及肝损伤类型也显示出显著相关性。