射频消融术联合DC-CIK治疗中晚期肝细胞癌患者疗效及其对生命质量的影响研究*

doi:10.3969/j.issn.1672-5069.2018.05.026

实用肝脏病杂志 ›› 2018, Vol. 21 ›› Issue (5): 757-760.doi: 10.3969/j.issn.1672-5069.2018.05.026

射频消融术联合DC-CIK治疗中晚期肝细胞癌患者疗效及其对生命质量的影响研究^*

胡洪生, 孙少华, 沈丰, 吴红伟, 伍伦, 周文波

442008湖北省十堰市湖北医药学院附属东风医院肝胆胰甲状腺外科

收稿日期:2018-01-24 出版日期:2018-09-10 发布日期:2018-09-27
作者简介:胡洪生，男，38岁，硕士研究生，主治医师。主要从事肝胆胰甲状腺外科疾病基础与临床研究。E-mail:huhongsheng2000@163.com
基金资助:
湖北省教育厅科研项目（编号：Q20162112）; 十堰市科技局科研项目（编号：16Y061）

Efficacy of radiofrequency ablation combined with DC-CIK in the treatment of patients with advanced hepatocellular carcinoma and its effect on the quality of life

Hu Hongsheng, Sun Shaohua, Shen Feng, et al.

Department of Hepatobiliary,Pancreatic and Thyroid Surgery,Dongfeng Hospital Affiliated to Hubei Medical and Pharmaceutical College,Shiyan 442008,Hubei Province,China

Received:2018-01-24 Online:2018-09-10 Published:2018-09-27

摘要/Abstract

摘要： 目的探讨采用射频消融术（RFA）联合树突状细胞（DC）-细胞因子诱导的杀伤细胞（CIK）治疗中晚期肝细胞癌（HCC）患者的疗效及其对患者生活质量的影响。方法 2013年9月2016年9月在我院治疗的中晚期（ⅢB~Ⅳ期）HCC患者144例,随机分为联合组72例和对照组72例。给予两组患者DC-CIK治疗,另一组在此基础上行RFA术。采用QLQ-C30生活质量调查表评价患者生活质量。结果在治疗后,联合组客观有效率（ORR）为70.8%,疾病控制率（DCR）为90.3%,显著高于对照组的40.3%和72.2%,联合组无进展生存期（PFS）为（13.2±3.1）m,显著长于对照组的【（10.5±3.3）m,P<0.05】;联合组血清AFP、CEA和CA-199水平分别为（240.5±28.7） ng/ml、（100.8±20.4） ng/ml和（210.8±52.4） U/ml,均显著低于对照组的【（320.4±70.1） ng/ml、（129.4±30.7） ng/ml和（320.7±40.9） U/ml,P<0.05】;联合组躯体功能、角色功能、情感功能、认知功能和社会功能评分均显著高于对照组（P<0.05）。结论 RFA联合DC-CIK治疗中晚期HCC患者近远期疗效较好,并且能更好地改善患者的生活质量。

关键词: 肝细胞癌, 过继免疫, 树突状细胞-细胞因子诱导的杀伤细胞, 射频消融术, 生活质量

Abstract: Objective To investigate the efficacy of radiofrequency ablation （RFA） combined with DC-CIK in the treatment of patients with advanced hepatocellular carcinoma（HCC） and its effect on the quality of life. Methods 144 patients with HCC at ⅢB~Ⅳ stage were recruited in our hospital between September 2013 and September 2016,and were randomly divided into combination and and control group with 72 patients in each group. The patients in both groups were treated with RFA,and 72 out of them received DC-CIK therapy and RFA combination. The quality of life was evaluated by QLQ-C30 questionnaire. Results The objective response rate （ORR） was 70.8%,and the disease control rate （DCR） was 90.3% in the combination group,much higher than 40.3% and 72.2% in the control,and progress-free survival（PFS） was（13.2±3.1） m,much longer than 【（10.5±3.3）m,P<0.05】 in the control;serum AFP,CEA and CA-199 levels were （240.5±28.7） ng/ml,（100.8±20.4） ng/ml and （210.8±52.4） U/ml,much lower than 【（320.4±70.1） ng/ml,（129.4±30.7） ng/ml and （320.7±40.9） U/ml,P<0.05】,respectively in the control;the physical,role’s,emotional,cognitive and social functions in the combination were much higher than those in the control（P<0.05）. Conclusions RFA combined with DC-CIK therapy in the treatment of patients with advanced HCC is in short and long term efficient,which improve the quality of life of the patients.

Key words: Hepatocellular carcinoma, Adoptive immunotherapy, DC-CIK, Radiofrequency ablation, Quality of life

胡洪生, 孙少华, 沈丰, 吴红伟, 伍伦, 周文波. 射频消融术联合DC-CIK治疗中晚期肝细胞癌患者疗效及其对生命质量的影响研究^*[J]. 实用肝脏病杂志, 2018, 21(5): 757-760.

Hu Hongsheng, Sun Shaohua, Shen Feng, et al.. Efficacy of radiofrequency ablation combined with DC-CIK in the treatment of patients with advanced hepatocellular carcinoma and its effect on the quality of life[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(5): 757-760.

参考文献

[1] Jemal A,Bray F,Center MM,et al.Global cancer statistics,2012. Ca A Cancer J Clin,2015,65(2):87-101.
[2] Ferlay J,Shin HR,Bray F,et al.Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer,2010,127(12):2893-2917.
[3] Attwa MH,El-Etreby SA.Guide for diagnosis and treatment of hepatocellular carcinoma. World J Hepatol,2015,7(12):1632-1651.
[4] Elfattah MA,Aboelmagd M,Elhamouly M.Prognostic factors of hepatocellular carcinoma survival after radiofrequency ablation:A US population-based study. Unit Eur Gastroenterol J,2017,5(2):227-235.
[5] Restifo NP,Dudley ME,Rosenberg SA.Adoptive immunotherapy for cancer:harnessing the T cell response. Nat Rev Immunol,2012,12(4):269-281.
[6] Yuanying Y,Lizhi N,Feng M,et al.Therapeutic outcomes of combining cryotherapy,chemotherapy and DC-CIK immunotherapy in the treatment of metastatic non-small cell lung cancer. Cryobiology,2013,67(2):235-240.
[7] 吴照宇. 中、晚期肝癌介入治疗预后的影响因素分析. 实用肝脏病杂志,2015,18(4):427-429.
[8] Palmer D,Midgley RN,Torr E,et al.A phase II study of adoptive immunotherapy using dendritic cells pulsed with tumor lysate in patients with hepatocellular carcinoma. Hepatology,2009,49(1):124-132.
[9] 吕淑敏,许尔蛟,郑荣琴,等. 原发性肝癌热消融后局部肿瘤进展的后继治疗及疗效分析. 中华肝脏外科手术学电子杂志,2016,5(3):163-167.
[10] Phillips R,Gandhi M,Cheung YB,et al.Summary scores captured changes in subjects' QoL as measured by the multiple scales of the EORTC QLQ-C30. J Clin Epidemiol,2015,68(8):895-902.
[11] Edeline J,Boucher E,Rolland Y,et al.Comparison of tumor response by Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST in patients treated with sorafenib for hepatocellular carcinoma. Cancer,2012,118(1):147-156.
[12] Sucandy I,Cheek S,Golas BJ,et al.Longterm survival outcomes of patients undergoing treatment with radiofrequency ablation for hepatocellular carcinoma and metastatic colorectal cancer liver tumors. HPB (Oxford),2016,18(9):756-763.
[13] Lafaro K,Grandhi MS,Herman JM,et al.The importance of surgical margins in primary malignancies of the liver. J Surg Oncol,2016,113(3):296-303.
[14] 张崇高,王国林. 肝动脉化疗栓塞联合微波消融治疗原发性肝癌临床疗效分析. 实用肝脏病杂志,2011,14(5):378-379.
[15] Suh S,Choi YS.Selection criteria of surgical resection for patients with Barcelona clinic liver cancer classification B hepatocellular carcinoma. J Hepatol,2016,64(2):S551-S551.
[16] Jacobs A.Radiofrequency ablation for liver cancer. Radiol Technol,2015,86(6):645-664.
[17] He ZX,Pu X,Gong JP,et al.Radiofrequency ablation versus resection for Barcelona clinic liver cancer very early/early stage hepatocellular carcinoma:a systematic review. Ther Clin Risk Manag,2016,12(1):295-303.
[18] Boeck CL,Amberger DC,Doraneh-Gard F,et al.Significance of frequencies,compositions,and/or antileukemic activity of (DC-
stimulated) invariant NKT,NK and CIK cells on the outcome of patients with AML,ALL and CLL. J Immunother,2017,40(6):224-248.
[19] Dolscheid-Pommerich RC,Manekeller S,Walgenbach-Brünagel G,et al.Clinical performance of CEA,CA19-9,CA15-3,CA125 and AFP in gastrointestinal cancer using LOCI-based assays. Anti Res,2017,37(1):353-360.
[20] Aaronson NK,Ahmedzai S,Bergman B,et al.The European Organization for Research and Treatment of Cancer QLQ-C30:a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst,1993,85(5):365-376.

射频消融术联合DC-CIK治疗中晚期肝细胞癌患者疗效及其对生命质量的影响研究^*

Efficacy of radiofrequency ablation combined with DC-CIK in the treatment of patients with advanced hepatocellular carcinoma and its effect on the quality of life

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	曹策, 郁义星, 王贝贝, 赵卫峰. 增强磁共振成像联合血清甲胎蛋白和脱-γ-羧基凝血酶原诊断肝细胞癌临床价值探讨[J]. 实用肝脏病杂志, 2019, 22(6): 896-899.
[2]	朱俊, 丁莹, 王世清, 张野, 刘野, 刘泽刚. 围手术期应用乌司他丁治疗对肝细胞癌患者肝切除术后外周血Th22细胞百分比和血浆白细胞介素-22的影响*[J]. 实用肝脏病杂志, 2019, 22(5): 720-723.
[3]	王刚, 赵洪波, 朱亚玲, 蒋保三, 张越美, 刁勇. 基于数据库分析肝细胞癌细胞XPO5基因水平变化及其临床意义*[J]. 实用肝脏病杂志, 2019, 22(5): 724-727.
[4]	戴青云, 王润东, 荚卫东. 术前预后营养指数评估肝细胞癌患者肝切除术后早期肿瘤复发价值探讨^*[J]. 实用肝脏病杂志, 2019, 22(4): 561-564.
[5]	杨富存, 尚怀学, 盖永浩. 钆塞酸二钠增强磁共振扫描诊断肝脏局灶性病变研究^*[J]. 实用肝脏病杂志, 2019, 22(4): 577-580.
[6]	彭新健, 肖玉辉, 许斯鼎, 石荣跃, 王耀政, 王瑜琳. 放射性肝损伤患者肝脏磁共振扩散加权成像表现特征分析[J]. 实用肝脏病杂志, 2019, 22(3): 373-376.
[7]	乔志忠. 超声造影定量分析鉴别肝脏局灶性结节性增生与原发性肝癌初步探讨[J]. 实用肝脏病杂志, 2019, 22(3): 421-424.
[8]	朱光曦（综述）, 文良志, 陈东风（审校）. 非酒精性脂肪性肝病相关肝细胞癌发病机制研究进展[J]. 实用肝脏病杂志, 2019, 22(3): 453-456.
[9]	王虎明,樊东升,徐杰,刘险峰,周宁,丽敏,包娜娜. 肝细胞癌患者癌组织miRNA-30c水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2019, 22(2): 248-251.
[10]	幸奠奎,程婧. ¹⁸F-FDG PET/CT检查指标预测肝细胞癌微血管侵犯临床价值研究^*[J]. 实用肝脏病杂志, 2019, 22(2): 252-254.
[11]	王秀清,马艳君,詹晋莉. 肝动脉化疗栓塞术联合超声引导下微波消融术治疗特殊部位原发性肝癌患者疗效及安全性分析 ^*[J]. 实用肝脏病杂志, 2019, 22(2): 260-263.
[12]	张小舟,帅领,王庆大,杨楠. 接受TACE治疗的肝细胞癌患者血清miR-335水平变化及其对预后判断的价值分析^*[J]. 实用肝脏病杂志, 2019, 22(2): 268-271.
[13]	王朝霞,关珂,付三仙,王慧杰. 肠内肠外联合营养支持治疗肝细胞癌患者围术期临床研究^*[J]. 实用肝脏病杂志, 2019, 22(2): 272-275.
[14]	赵西太综述,聂青和审校. 循环microRNA早期诊断肝细胞癌研究现状及方法学探讨[J]. 实用肝脏病杂志, 2019, 22(2): 297-300.
[15]	范建高. 2018年《实用肝脏病杂志》精彩回顾[J]. 实用肝脏病杂志, 2019, 22(1): 1-3.