经动脉化疗栓塞联合高强度聚焦超声治疗高龄原发性肝癌的临床研究
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摘要
目的:研究经动脉化疗栓塞联合高强度聚焦超声治疗高龄原发性肝癌患者的临床效果,为临床治疗提供参考。方法:200例高龄原发性肝癌患者分别进行动脉化疗栓塞术和动脉化疗栓塞术联合高强度聚焦超声治疗,观察患者治疗效果及治疗前后ERK通路相关蛋白分子表达,并与本院同期200例健康体检者进行对照。结果:与动脉栓塞术治疗患者相比,动脉化疗栓塞术联合高强度聚焦超声治疗高龄原发性肝癌患者的Child-Pugh评分明显降低(P<0.05),且生存率明显高于动脉栓塞治疗患者(P<0.05);治疗后患者血清中促凋亡蛋白P53、Caspase6、Caspase9、Laminin(层黏连蛋白)5γ2、E-cadherin(钙粘蛋白)、β-catenin(β链蛋白)、ERK通路蛋白、HIF(缺氧诱导因子)α和COX2(环氧酶2)及基质金属蛋白酶表达明显升高(P<0.05),而C-myc表达明显降低(P<0.05)。结论:经动脉化疗栓塞联合高强度聚焦超声治疗高龄原发性肝癌的效果与其抑制患者体内激活的ERK通路有关。
Objective: To explore the effect of hepatic artery embolism chemotherapy combined with high intensity focused ultrasound on primary hepatic cancer in elderly patients. Methods: 200 cases of elderly primary hepatic cancer patients in our department from Jan 2012 to Dec 2016 were enrolled in this part. The effect and regulation on ERK signaling pathway related proteins were assayed after the medication of hepatic artery embolism chemotherapy combined high intensity focused ultrasound. 200 healthy subjects in our hospital at the same time were taken as control. Results: The results showed that the Child-Pugh scores were decreased greatly( P < 0. 05) while the survival rate were improved( P < 0. 05) after the medication of hepatic artery embolism chemotherapy combined with high intensity focused ultrasound. The results also showed that the proteins including P53,Caspase6,Caspase9,Laminin5γ2,E-cadherin,β-catenin,ERK related proteins,HIFα and COX2 were increased greatly( P < 0. 05),while the C-myc was decreased significantly( P < 0. 05). Conclusion: Hepatic artery embolism chemotherapy combined with high intensity focused ultrasound was effective on primary hepatic cancer in elderly patients which maybe related with the regulation of activated ERK pathway.
Objective: To explore the effect of hepatic artery embolism chemotherapy combined with high intensity focused ultrasound on primary hepatic cancer in elderly patients. Methods: 200 cases of elderly primary hepatic cancer patients in our department from Jan 2012 to Dec 2016 were enrolled in this part. The effect and regulation on ERK signaling pathway related proteins were assayed after the medication of hepatic artery embolism chemotherapy combined high intensity focused ultrasound. 200 healthy subjects in our hospital at the same time were taken as control. Results: The results showed that the Child-Pugh scores were decreased greatly( P < 0. 05) while the survival rate were improved( P < 0. 05) after the medication of hepatic artery embolism chemotherapy combined with high intensity focused ultrasound. The results also showed that the proteins including P53,Caspase6,Caspase9,Laminin5γ2,E-cadherin,β-catenin,ERK related proteins,HIFα and COX2 were increased greatly( P < 0. 05),while the C-myc was decreased significantly( P < 0. 05). Conclusion: Hepatic artery embolism chemotherapy combined with high intensity focused ultrasound was effective on primary hepatic cancer in elderly patients which maybe related with the regulation of activated ERK pathway.
引文
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[15]白琛,唐芳,杨茹,等.肝动脉化疗栓塞联合恩替卡韦治疗乙型肝炎相关性原发性肝细胞癌的疗效及其对炎性因子和免疫功能的影响[J].兰州大学学报(医学版),2016,42(15):10-15.
[16]蒋富强,卢伟,杨超.肝动脉化疗栓塞联合射频消融治疗原发性肝癌的疗效及对血清学指标的影响[J].海南医学院学报,2016,22(15):807-810.
[17]周文.肝动脉化疗栓塞术和热灌注化疗治疗肝癌的效果比较[J].中国医药导报,2015,12(36):94-97.
[18]杨敏,李欢,袁世梅,等.高强度聚焦超声治疗小鼠皮下瘤后IL-6和IL-10表达的变化[J].第三军医大学学报,2015,37(4):1314-1318.
[19]李京涛,郭师,席奇,等.益脾养肝方联合肝动脉化疗栓塞术治疗原发性肝癌的疗效观察[J].陕西中医,2015,36(8):944-945.
[2]刘尧,王宇,雷光焰,等.TACE联合放射性粒子组织间放疗对原发性肝癌患者恶性生物学指标的影响[J].海南医学院学报,2016,5(14):226-229.
[3]王其美,王容容,张迪,等.口服肝喜片配合三氧化二砷行肝动脉灌注化疗栓塞术治疗肝郁脾虚型原发性肝癌的临床研究[J].中华中医药杂志,2016,31(3):1121-1125.
[4]原强,靳勇,白旭明,等.经肝动脉化疗栓塞联合射频消融治疗原发性肝癌及术后复发性肝癌的疗效比较及预后因素分析[J].中国介入影像与治疗学,2016,13(95):146-150.
[5]刘丹,赵忠新,迟大鹏,等.ERK1/2通路对Genistein与5-FU诱导的人肝癌细胞周期阻滞的影响[J].世界华人消化杂志,2014,22(45):2134-2139.
[6]郑星星,张韧硕,周应军,等.ERK/Fox O3a信号轴在牡荆脂素VB-1抑制肝癌Hep G2细胞系增殖中的作用[J].中国中药杂志,2014,7(39):1276-1279.
[7]李杨,冯丽,陈娟,等.ALC1介导的MAPK信号通路激活对肝癌细胞增殖的影响[J].解剖学研究,2016,38(1):48-51.
[8]张朝亚,赵相轩,卢再鸣,等.索拉非尼诱导肝癌细胞凋亡信号通路的研究进展[J].临床肝胆病杂志,2016,32(4):816-820.
[9]别彩群,黄秋燕,颜英,等.RNAi介导的IGF1R基因沉默对肝癌细胞生长、迁移与侵袭的影响[J].中国病理生理杂志,2015,31(12):2136-2143.
[10]樊伍峰,李郝.地西他滨联合丙戊酸钠促进肝癌细胞凋亡的ERK通路研究[J].中国免疫学杂志,2016,32(1):33-36.
[11]姚亮,李慧玲,董建一,等.低水平活性氧对Ras癌基因诱导肝肿瘤发生的影响[J].中华肿瘤防治杂志,2015,22(12):911-916.
[12]曹文丽,温晓玉.上皮细胞转化序列2调控Rho/ERK信号转导通路促使肝癌早期复发[J].临床肝胆病杂志,2015,3(7):1109.
[13]韩丽,陈彻,楚惠媛,等.As2O3联合AZT作用对肝癌Hep G2细胞迁移和侵袭的影响[J].肿瘤,2015,35(9):982-989.
[14]崔海鹏,董建一,姚亮,等.m TOR与ERK对Hep3B细胞cyclin D1表达的协同调控分子机制[J].中华肿瘤防治杂志,2015,22(17):1352-1356.
[15]白琛,唐芳,杨茹,等.肝动脉化疗栓塞联合恩替卡韦治疗乙型肝炎相关性原发性肝细胞癌的疗效及其对炎性因子和免疫功能的影响[J].兰州大学学报(医学版),2016,42(15):10-15.
[16]蒋富强,卢伟,杨超.肝动脉化疗栓塞联合射频消融治疗原发性肝癌的疗效及对血清学指标的影响[J].海南医学院学报,2016,22(15):807-810.
[17]周文.肝动脉化疗栓塞术和热灌注化疗治疗肝癌的效果比较[J].中国医药导报,2015,12(36):94-97.
[18]杨敏,李欢,袁世梅,等.高强度聚焦超声治疗小鼠皮下瘤后IL-6和IL-10表达的变化[J].第三军医大学学报,2015,37(4):1314-1318.
[19]李京涛,郭师,席奇,等.益脾养肝方联合肝动脉化疗栓塞术治疗原发性肝癌的疗效观察[J].陕西中医,2015,36(8):944-945.