肝癌肝移植术前降期中载药微球经动脉化疗栓塞应用效果观察

doi:10.3969/j.issn.1006-6233.2023.07.024

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Abstract Objective: To investigate the value of drug-laden microsphere transarterial chemoembolization (DEB-TACE) versus conventional transarterial chemoembolization (cTACE) in the preoperative descending treatment of liver cancer liver transplantation. Methods: The clinical data of 74 patients who underwent classical in situ liver transplantation for hepatocellular carcinoma (HCC) in our hospital from January 2015 to January 2022 were collected for a retrospective study.Among them,36 cases underwent DEB-TACE downstaging treatment before liver transplantation as the DTACE group and 38 cases underwent cTACE downstaging treatment before liver transplantation as the cTACE group.The efficacy of the step-down treatment,serum tumor markers[alpha-fetoprotein (AFP),glycoantigen 199 (CA199),E-calcine mucin (EC)],liver function indexes[aspartate aminotransferase (AST),total bilirubin (TBIL),alanine aminotransferase (ALT)],prognosis-related markers[vascular endothelial growth factor (VEGF),secretory protein Dickkopf-1 (DKK1),CD24],incidence of adverse events,and recurrent metastases 1 year after liver transplantation. Results: There was no statistically significant difference (P>0.05) between the remission rate of the DTACE group on descending treatment (83.33%) and the cTACE group (71.05%); serum AFP,CA199 and EC levels were lower in the DTACE group than in the cTACE group after treatment (P<0.05).Serum AST,TBIL and ALT levels were lower in the DTACE group than in the cTACE group after treatment (P<0.05); serum VEGF,DKK1 and CD24 levels were lower in the DTACE group than in the cTACE group after treatment (P<0.05).There was no statistically significant difference in the incidence of nausea/vomiting,abdominal pain,fever,and liver abscess in the DTACE group (11.11%,16.67%,69.44%,2.78%) compared with the cTACE group (18.42%,21.05%,76.32%,7.89%) (P>0.05); the recurrence rate and metastasis rate 1 year after liver transplantation in the DTACE group ( 5.56%,10.53%) compared with the cTACE group (11.11%,18.42%) were not statistically significant (P>0.05). Conclusion: Both DEB-TACE and cTACE can achieve good therapeutic effects in the preoperative descending treatment of liver cancer liver transplantation,among which DEB-TACE can more significantly downregulate serum tumor markers and prognosis-related markers levels,and has obvious advantages in protecting liver function.

Key words： Hepatocellular carcinoma Liver transplantation Step-down therapy Drug-laden microspheres Transarterial chemoembolization

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.07.024 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I7/1183

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