The Effect And Study Of Mechanism Of S-TACE Combining With Apatinib For Treatment Of Primary Hepatocellular Carcinoma

Objective To explore the expression andclinical significance of the angiogenesis factors in serum and HCC tissue for the treatment ofprimary hepatocellular carcinoma by S-TACE combined with apatinibMethods A total of 46 HCC patientswere collected in our hospital from January 2015 to June 2015,dividing into two groups:simple S-TACE group(Group A,n=23)and S-TACE combined with apatinib(Group B,n=23).Detection of all patients'serum levels of VEGF,HIF-1? and liver function pre-and post-treatment,determination ofa part of patients'(20 cases)VEGFR-2 and MVD with immunohistochemical method in tumor tissuesobtained by ultrasound guided liver biopsy pretreatment and posttreatment 4 weeks.According to the 46 HCC patients lesions change showed by enhanced CT in pretreatment and posttreatment 4st week,comparing DCR and OR between the two groups.Observe the adverse reactions related to S-TACE and apatinib.To analysis the progress of the disease by following up HCC patients of 3 months to 2 years.Results 1.The levels of AST,ALT,TBIL and DBIL were significantly higher in the two groups posttreatment compared with pretreatment(P<0.05),but there was no significant difference between group A and group B.2.Compared with pretreatmentthe serum concentration of VEGF and HIF-1? in group Awas increased posttreatment 1st week and decreased posttreatment 4st week;in group B the serum concentration of VEGFand HIF-1? continued todecreased(P<0.05);group B decreased more significantly(P<0.05)3.Compared with pretreatment theexpression of VEGFR-2 and MVD of HCC tissues of the two groups were reduced(P<0.05),group B decreased more significantly(P<0.05).4.Compared with pretreatment tumor diameter of the two groups were reduced(P<0.05),group B decreased more significantly(P<0.05).5.The group B posttreatment DCR was 95.65%and OR was 60.87%,the group A posttreatment DCR was 82.61%and OR was 34.78%.While group B was higher than group A,but no statistically significant difference(P>0.05).6.The TTP of group B was(11.72±4.94)m,group A TTP is(8,15±4.74)m.The TTP ofGroup Bwas longer than that of group A,there wassignificant difference between two groups(P<0.05).Conclusion1.The effectof S-TACE combined with apatinib is better than simple S-TACE,the mechanism is related to the inhibition angiogenesis of tumor.2.S-TACE combined with apatinib can extend the TTP,improve the prognosis.