实用肝脏病杂志 ›› 2021, Vol. 24 ›› Issue (6): 907-910.doi: 10.3969/j.issn.1672-5069.2021.06.035

• 肝癌 • 上一篇    下一篇

射频消融术治疗原发性肝癌患者接受胸腺素α1维持治疗临床价值探讨*

周颜, 李国平, 邓俊, 杨美蓉, 吴晓霞, 张英, 朱宏英, 陈卫   

  1. 214011 江苏省无锡市第五人民医院介入科(周颜,邓俊,杨美蓉,吴晓霞,张英,朱宏英,陈卫);复旦大学附属中山医院介入科(李国平)
  • 收稿日期:2020-10-28 发布日期:2021-11-15
  • 通讯作者: 陈卫,E-mail:cw681108@163.com
  • 作者简介:周颜,女,40岁,大学本科,主治医师

Efficacy of thymosin alpha 1 in maintained treatment of patients with primary liver cancer after radiofrequency ablation

Zhou Yan, Li Guoping, Deng Jun, et al   

  1. Department of Interventional Radiology, Fifth People's Hospital, Wuxi 214011, Jiangsu Province, China
  • Received:2020-10-28 Published:2021-11-15

摘要: 目的 探讨在射频消融术(RFA)治疗原发性肝癌(PLC)后应用胸腺素α1维持治疗的意义。方法 在75例单发小于5 cm的PLC患者,在超声引导下行经皮RFA治疗,术后部分患者继续应用胸腺素α1 治疗3个月。采用ELISA法检测血清细胞因子水平。随访36个月,观察无复发生存率(RFS)的差异。结果 治疗后,35例联合组一次性治疗达到完全应答率为80.0%,40例RFA治疗组为82.5%,经补救治疗,两组均达到100.0%完全应答;在术后3月末,两组外周血T细胞亚群变化无统计学差异,但联合治疗组血清IL-2和IFN-γ水平分别为34.5(26.7,39.6)ng/L和77.2(74.4,82.7)ng/L,显著高于RFA治疗组【分别为26.8(22.3,28.4)ng/L和64.6(59.7,75.9)ng/L,P<0.05】;联合组中位RFS为26个月,RFA治疗组为23个月,差异无统计学意义;联合组1 a、2 a和3 a RFS分别为62.9%、28.6%和5.7%,而单行RFA治疗组分别为55.0%、17.5%(P<0.05)和0.0%,提示在RFA术后应用胸腺素α1治疗有一定的效果;多因素分析显示是否应用胸腺素α1治疗、病灶大于3 cm、特殊部位的病灶和治疗后是否获得CR等影响RFA治疗后患者的预后。结论 在RFA治疗PLC患者后应用胸腺素α1维持治疗可能能进一步提升治疗效果,可能与提高了机体抗肿瘤细胞免疫功能有关,值得进一步观察。

关键词: 原发性肝癌, 射频消融术, 胸腺素α1 , 无复发生存

Abstract: Objective The aim of this study was to investigate the efficacy of thymosin alpha 1 in maintained treatment of patients with primary liver cancer (PLC) after radiofrequency ablation (RFA). Methods A total of 75 patients with PLC and single-focal less than 5 cm were enrolled in our hospital, and all patients with PLC underwent RFA and were followed-up for 36 months to observe the relapse-free survival (RFS). After the interventional management, 35 patients received and 40 patients didn't received thymosin alpha 1 for maintained treatment for three months. Serum cytokines were detected by ELISA. Results The complete response (CR) after once RFA treatment in combination group was 80.0%, and in RFA-treated group was 82.5% (P<0.05), and all patients in the two groups got CR after second RFA or TACE; at the end of three month, there were no significant differences as respect to the changes of peripheral blood lymphocyte subset percentages (P>0.05), while serum IL-2 and IFN-γ levels in the combination group were 34.5(26.7,39.6)ng/L and 77.2(74.4,82.7)ng/L, significantly higher than [26.8(22.3, 28.4)ng/L and 64.6(59.7,75.9)ng/L, respectively, P<0.05] in the RFA-treated group; the median RFSs in the combination and control group were 26 months and 23 months (P>0.05), and the 1-year, 2-year and 3-year RFSs were 62.9%, 28.6% and 5.7%, some significantly different as compared to 55.0%, 17.5%(P<0.05) and 0.0% in RFA-treated group; the multivariate analysis showed that the application of thymosin alpha 1, size of foci, special foci and CR after treatment were the independent factors impacting the prognosis of patientswith PLC after RFA treatment. Conclusion The administration of thymosin alpha 1 for maintained treatment after RFA might improve the survival of patients with PLC, which needs further investigation.

Key words: Hepatoma, Radiofrequency ablation, Thymosin alpha 1, Relapse-free survival