经肝动脉化疗栓塞术联合经皮穿刺射频消融治疗原发性肝癌疗效  

Outcomes of transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in treating primary hepatic carcinoma

作　　者：杨广辉[1] 刘立民[2] 韩正祥[3] 胡春峰[3] 

机构地区：[1]沛县人民医院超声科,江苏省221600 [2]徐州医学院附属淮安医院血液科 [3]徐州医学院附属医院肿瘤科

出　　处：《江苏医药》2014年第9期1038-1041,共4页Jiangsu Medical Journal

基　　金：徐州市科技发展基金项目(XF11C106)

摘　　要：目的探讨经肝动脉化疗栓塞术(TACE)联合超声引导经皮穿刺射频消融(PRFA)治疗原发性肝癌(PHC)的疗效。方法 PHC患者42例均分为TACE联合PRFA治疗(32个病灶,A组)和TACE治疗(33个病灶,B组)。流式细胞术检测治疗前后肝癌组织中T细胞水平,定期行彩超检查肿瘤大小,并动态监测肝功能、甲胎蛋白和随访观察生存情况。结果治疗后,A组有效率高于B组(90.6%vs.69.7%)(P<0.05),肿瘤血流消失率高于B组(95.2%vs.38.1%)(P<0.05),CD4+T细胞比例低于B组[(2.78±0.81)%vs.(4.21±1.52)%](P<0.05),CD8+T细胞比例高于B组[(12.85±3.45)%vs.(8.19±2.49)%](P<0.05)。A和B组6、12、18个月的生存率分别为83.67%、55.00%、37.50%和70.83%、37.50%、20.82%。结论 TACE联合PRFA治疗PHC是微创、有效、安全的方法,可提高PHC患者的生存率。Objective To observe the outcomes of transcatheter arterial chemoembolization （TACE） combined with percutaneous radiofrequency ablation（PRFA） in treating primary hepatic earcinoma（PHC）. Methods Forty-two PHC patients were equally divided into groups of A（treated with TACE plus PRFA, 32 lesions） and B（treated with TACE alone, 33 lesions）. T cells in PHC were detected by flow cytometry before and after treatment. The tumor size was checked by color Doppler ultrasound. Liver function and alpha fetal protein were monitored dynamically and survival rate was followed up. Results After treatment, the effectiveness rate was higher in group A than that in group B（90.6% vs. 69.7%）（P〈0. 05）. So did the disappearance rate of blood flow in tumor（95.2 % vs. 38.1%） （P〈0. 05）. The percentage of CD4^＋ T cells was lower in group A than that in group B[（2.78 ±0.81） % vs. （4. 21± 1.52）%] （P〈0. 05）, which of CD8^＋ T cells was higher in group A than that in group B[（12.85±3.45）% vs. （8. 19±2. 49）%] （P〈0. 05）. The survival rates of group A were 83.67%, 55.00% and 37.50%, respectively for the 6^th, 12^th and 18^th month after treatment, which of group B were 70. 83%, 37.50% and 20.82%. Conclusion Combined use of TACE and RFA is effective,minimally invasive and safe in the treatment of patients with PHC.

关 键 词：原发性肝癌 经肝动脉化疗栓塞术 经皮射频消融术 

分 类 号：R735[医药卫生—肿瘤]