肝细胞癌Adv―p53AAV―HGFK1联合转基因治疗临床疗效和预后分析.docVIP

肝细胞癌Adv―p53AAV―HGFK1联合转基因治疗临床疗效和预后分析 　　[摘要] 目的 分析肝细胞癌Adv-p53、AAV-HGFK1联合转基因治疗的临床疗效和预后。 方法 选取我科2009年1月～2012年1月进展期肝癌患者共50例，随机分为重组腺相关病毒-肝细胞生长因子第l螺旋区（recombinant adeno-associated virus-kringle 1 domain of hepatocyte growth factor）AAV-HGFK1+Adv-p53组和AAV-HGFKI组。比较两组患者治疗后肝穿刺活检标本新生微血管和凋亡细胞率、临床疗效、复发率、生存率。 结果 AAV-HGFK1+Adv-p53组治疗后第14天、第21天的新生微血管数量显著低于AAV-HGFK1组，凋亡细胞率显著高于AAV-HGFK1组（P0.05）。AAV-HGFK1+Adv-p53组1年、3年复发率显著低于AAV-HGFK1组，1年、3年生存率显著高于AAV-HGFK1组（P0.05）。 结论 Adv-p53、AAV-HGFK1联合治疗进展期肝细胞癌疗效优于AAV-HGFK1单独治疗，预后更佳。 　　[关键词] Adv-p53；AAV-HGFK1；转基因治疗；肝细胞癌；预后 　　[中图分类号] R735.7 [文献标识码] A [文章编号] 1673-9701（2015）26-0008-04 　　Clinical efficacy and prognosis of Adv-p53， AAV-HGFK1 combined gene therapy for HCC 　　ZHANG Fabiao FANG Zheping 　　Department of Hepatobiliary Surgery， Taizhou Hospital in Zhejiang Province， Linhai 317000， China 　　[Abstract] Objective To analyze the clinical efficacy and prognosis of Adv-p53， AAV-HGFK1 combined gene therapy for HCC. Methods Fifty patients with advanced liver cancer in our department from January 2009 to January 2012 were randomly divided into AAV-HGFK1+Adv-p53 group and AAV-HGFK1 group. The liver biopsy specimens’ microvessel and apoptosis rate， clinical efficacy and relapse rate were compared in two groups of patients. Results The number of microvessels in AAV-HGFK1+Adv-p53 group 14 days and 21 days was significantly lower than AAV-HGFKI group. The apoptosis rate was significantly higher than that of AAV-HGFK1 group（P0.05）. The 1，3-year recurrence rate in the AAV-HGFK1+Adv-p53 group was significantly lower than AAV-HGFK1 group， the 1，3-year survival rate was significantly higher than that of AAV-HGFK1 group（P0.05）. Conclusion Adv-p53， AAV-HGFK1 combination therapy for advanced hepatocellular carcinoma is more effective than AAV-HGFK1 alone treatment， while the prognosis is better. 　　[Key words] Adv-p53； AAV-HGFK1； Gene therapy； Hepatocellular carcinoma； Prognosis 　　原发性肝癌为我国特别是农村地区高发恶性消化道肿瘤之一，由于其早期临床主要表现为右下腹隐痛、呕心呕吐以及消化不良等胃肠道非特异性表现，故早期阳性诊断水平较低