射频消融联合TACE治疗原发性肝癌患者疗效及对外周血T细胞亚群的影响

doi:10.3969/j.issn.1672-5069.2017.03.017

摘要/Abstract

摘要： 目的探讨射频消融联合TACE治疗原发性肝癌患者的疗效及其对外周血T细胞亚群的影响。方法 2014年1月~2016年2月间于我院接受TACE治疗的原发性肝癌患者97例,按照TACE术后是否接受射频消融治疗,将患者分为联合组52例和TACE组45例。采用ELISA法检测血清细胞因子。对两组患者的治疗效果、治疗前后T细胞亚群变化情况以及治疗后生存质量进行比较。结果联合组总有效率为67.31%,显著高于TACE组的40.00% （P<0.05）;联合组疾病控制率为90.38%,显著高于TACE组的73.33%（P<0.05）;联合组治疗后3个月外周血CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值分别为（68.40±10.20）%、（45.76±6.83）%和（1.96±0.31）,均明显高于TACE组【（56.14±6.75）%、（33.27±5.16）%和（1.21±0.22）,P<0.05】,联合组CD8⁺T细胞百分比为（22.08±2.55）%,显著低于TACE组【（28.42±3.97）%,P<0.05】;联合组患者治疗后3个月外周血IL-6、IL-8和TNF-α水平分别为（129.45±67.14） pg/mL、（0.49±0.13） ng/mL和（134.78±88.20） pg/mL,均明显低于TACE组【（165.30±65.91）pg/mL、（0.72±0.20） ng/mL和（200.43±84.02）pg/mL,P<0.05】;联合组患者生活质量改善率为55.77%,显著高于TACE组的40.00%（P<0.05）,联合组患者并发症发生率为73.08%,与TACE组的71.11%相比无统计学差异（P>0.05）。结论射频消融联合TACE治疗原发性肝癌患者近期疗效较好,可改善患者免疫功能,提高生存质量。

关键词: 原发性肝癌, 射频消融, 经动脉化疗栓塞术, T细胞亚群, 生活质量

Abstract: Objective To investigate the clinical efficacy of radiofrequency ablation（RFA） combined with transcatheter arterial chemoembolizatio（TACE） in treatment of patients with primary liver cancer （PLC）. Methods 97 patients with PLC were recruited in our hospital between January 2014 and February 2016. 52 patients with PLC received RFA plus TACE and 45 received TACE alone. Serum cytokines were detected by ELISA. The clinical efficacy,changes of peripheral blood T cell subset before and after treatment and life quality after treatment in the two groups were compared. Results The total effective rate in RFA plus TACE group was 67.31%,significantly higher than 40.00% in TACE group（P<0.05）;the disease control rate in combination group was 90.38%,significantly higher than 73.33% in TACE group （P<0.05）;he percentage of CD3⁺T cells,CD4⁺T cells and the ratio of CD4⁺/CD8⁺ 3 months after treatment in combination group were（68.40±10.20）%,45.76±6.83）% and（1.96±0.31）,respectively,all significantly higher than in TACE group[（56.14±6.75）%,（33.27±5.16）% and （1.21±0.22）,P<0.05],while the CD8⁺T cells was （22.08±2.55）%,significantly lower than （28.42±3.97）% in TACE group（P<0.05）;serum levels of IL-6,IL-8 and TNF-α 3 months after treatment in combination group were（129.45±67.14） pg/mL,（0.49±0.13） ng/mL and（134.78±88.20） pg/mL,respectively,significantly lower than in the TACE group [（165.30±65.91） pg/mL,（0.72±0.20） ng/mL and（200.43±84.02） pg/mL,P<0.05];the life quality improvement rate in RFA plus TACE group was 55.77%,significantly higher than 40.00% in TACE group（P<0.05） and the complication occurrence rate was 73.08%,which had no significant difference compared to 71.11% in TACE group. Conclusion RFA combined with TACE has better efficacy in treatment of patients with PLC with improved immune functions and life quality.

Key words: Primary liver cancer, Radiofrequency ablation, Transcatheter arterial chemoembolization, T cell subset, Life quality

邬振国, 陈永永, 李楠. 射频消融联合TACE治疗原发性肝癌患者疗效及对外周血T细胞亚群的影响[J]. 实用肝脏病杂志, 2017, 20(3): 324-327.

Wu Zhenguo, Chen Yongyong, Li Nan. Clinical efficacy of radiofrequency ablation combined with TACE in treatment of patients with primary liver cancer[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(3): 324-327.

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