肝癌患者RFA治疗前后血清中TNF和AFP的变化  

Changes of serum level of tumor necrosis factor and alpha fetoprotein in patients with primary hepatic cancer before and after radiofrequency ablation

作　　者：李金茂[1] 鲍恩武[2] 马庆久[1] 赖大年[1] 鲁建国[1] 高德明[1] 

机构地区：[1]第四军医大学唐都医院普通外科,陕西西安710038 [2]武警安徽省总队医院普通外科,安徽合肥230041

出　　处：《中国普通外科杂志》2005年第2期84-86,共3页China Journal of General Surgery

摘　　要：　　目的　探讨原发性肝癌 (PHC)患者经集束电极射频热毁损 (RFA)治疗后血清中肿瘤坏死因子 (TNF)及甲胎蛋白 (AFP)的变化及其与患者免疫功能变化的相关性,以监测RFA治疗PHC的疗效。方法　检测 1 1 2例PHC患者RFA治疗后血清中TNF和AFP的改变,并与健康对照组 2 0例比较,分析其与患者免疫功能变化的相关性。结果　PHC患者治疗前血清TNF和AFP水平明显高于健康对照组 (P< 0. 0 1 );治疗后 1周,血清TNF与治疗前比较无明显变化 (P> 0. 0 5 ),而AFP下降明显 (P< 0. 0 1 );治疗后 2周,血清TNF下降明显 (P< 0. 0 1 ),但仍高于对照组 (P < 0. 0 1 ),AFP降至正常,与对照组比较差异无显著性 (P> 0. 0 5 )。血清TNF与AFP水平变化无相关性 (r= 0. 1 9 5, P>0. 0 5 )。RFA治疗PHC近期效果明显。结论　原发性肝癌RFA治疗后血清中TNF及AFP水平下降,提示机体免疫功能增强,并有助于判断疗效及预后。Objective To investigate the changes of serum levels of TNF and AFP in patients with primary hepatocellular carcinoma(PHC) before and after radiofrequency ablation(RFA) and their correlation with changes in the patients′ immunological function,so as to monitor the therapeutic effect of RFA in PHC. Methods The serum levels of TNF and AFP were measured in 20 healthy individuals(control group) and in 112 patients with PHC (treatment group) pre RFA, post RFA. The results were compared and analysed for correlation with changes in the patients′ immunological function.Results Mean serum level of TNF and AFP in treatment group pre RFA was significantly higher than that of control group(P<0.01).At 7 days post RFA ,the serum level of TNF showed no significant change(P>0.05),but the level of AFP decreased significantly (P<0.01). At 14 days post RFA,the serum level of TNF decreased significantly (P< 0.01 ),but it was still higher than that of control group(P<0.01), and the serum level of AFP compared with that of control group was not significanly different(P>0.05).No relationship was found between changes in the levels of TNF and AFP(r=0.195,P>0.05). RFA showed a marked short term therapeutic effect for patients with PHC.Conclusions After RFA treatment of patients with PHC,the serum levels of TNF and AFP decreased,and this suggests an augmentation of organism immune function. The serum levels of TNF and AFP can assist in the assessment of the therapeutic effect and prognosis of primary hepatic carcinoma.

关 键 词：肝肿瘤/血液 肝肿瘤/治疗 射频热毁损 肿瘤坏化因子/血液 甲胎蛋白/血液 

分 类 号：R735.7[医药卫生—肿瘤] R454.1[医药卫生—临床医学]