射频消融联合DC-CIK治疗中晚期肝细胞癌的疗效评价  

Evaluation on clinical efficacy of radiofrequency ablation combined with DC-CIK in treating moderate and advanced hepatocellular caicinoma

作　　者：李金瑞[1] 钟鑫平[1] 

机构地区：[1]中国医科大学附属第一医院肝胆外科暨器官移植科,沈阳110001

出　　处：《检验医学与临床》2015年第19期2830-2833,共4页Laboratory Medicine and Clinic

基　　金：辽宁省科学技术计划项目(2011225019)

摘　　要：目的研究超声引导下射频消融术联合树突状细胞(DC)-细胞因子诱导的杀伤细胞(CIK)治疗中晚期肝细胞癌患者的临床疗效。方法选取100例诊断为中晚期肝细胞癌的患者随机分为治疗组与对照组,每组各50例。两组患者均给予DC-CIK免疫细胞治疗,治疗组在细胞治疗的基础上行超声引导下经皮腹腔穿刺射频消融术,观察两组临床疗效、不良反应与治疗前后外周血清肿瘤标志物的浓度及免疫功能。结果治疗后治疗组近期及远期临床疗效均优于对照组(P<0.05);治疗后两组外周血清甲胎蛋白(AFP)、H-亚基铁蛋白(HF)、癌胚抗原(CEA)、糖类抗原199(CA199)水平较治疗前有所降低(P<0.05)。治疗组外周血清CD3、CD8、CD56/CD3、CD16/CD3、IgG、IgM、IgA较治疗前有所升高(P<0.05),CD4/CD8较治疗前降低(P<0.05),CD4较治疗前无明显改变(P>0.05)。对照组外周血清CD3、CD8、CD4、CD4/CD8、CD56/CD3、CD16/CD3较治疗前无有所升高(P<0.05),对照组IgG、IgM、IgA较治疗前升高(P<0.05)。治疗后治疗组外周血清AFP、HF、CEA、CA199浓度均低于对照组(P<0.05);治疗组外周血清CD3、CD8、CD56/CD3、CD16/CD3、IgG、IgM、IgA明显高于对照组(P<0.05),CD4/CD8明显低于对照组(P<0.05),CD4较对照组差异无统计学意义(P>0.05)。两组治疗中均出现发热、寒战伴高热、皮疹;治疗组术后出现腹痛、恶心伴呕吐、肝周血肿。结论超声引导下射频消融术联合DC-CIK能提高中晚期肝细胞癌患者的临床疗效且不良反应较小。在治疗过程中全面、细致、规范的护理是治疗成功的重要前提。Objective To investigate the clinical efficacy of radiofrequency ablation combined with DC‐CIK in treating moderate and advanced hepatocellular caicinoma and its nursing experience .Methods 100 cases diagnosed as moderate and advanced hepatocellular caicinoma were selected and randomly divided into the treatment group and the control group ,50 cases in each group .The two groups were given the immune cell therapy of DC‐CIK ,while on this basis the treatment group was performed the radiofrequency ablation by percutaneous abdominal paracentesis under ultrasound guiding .The clinical efficacy ,adverse reactions and peripheral serum concentrations of tumor markers and immune function before and after treatment were observed in the two groups .Results The short term and long‐term clinical efficacies after treatment in the treatment group were significantly better than those in the control group（P〈0 .05） ;peripheral blood AFP ,HF ,CEA and CA199 levels after treatment in the two groups were decreased compared with before treatment（P〈 0 .05） ;peripheral serum CD3 ,CD8 ,CD56/CD3 ,CD16/CD3 ,IgG ,IgM and IgA after treat‐ment in the treatment group were increased compared with before treatment （P 〈 0 .05） ,while CD4/CD8 was de‐creased compared with before treatment（P〈 0 .05） ,CD4 had no change compared with before treatment（P〉 0 .05） . Peripheral serum CD3 ,CD8 ,CD4 ,CD4/CD8 ,CD56/CD3 ,CD16/CD3 after treatment in the control group were in‐creased compared with before treatment（P〈 0 .05） ,the IgG ,IgM and IgA levels after treatment were increased com‐pared with before treatment （P 〈 0 .05） .Peripheral serum AFP ,HF ,CEA and CA199 levels after treatment in the treatment group were lower than those in the control group（P 〈 0 .05） ;while peripheral serum CD3 ,CD8 ,CD56/CD3 ,CD16/CD3 ,IgG ,IgM and IgA were significantly higher than those in the control group（P〈 0 .05） ,serum CD4/CD8 was significantly lower than that in the control group（P〈 0 .05） and CD4 ha

关 键 词：中晚期肝细胞癌 射频消融术 DC-CIK 临床疗效 肿瘤标志物 免疫功能 护理 

分 类 号：R735.7[医药卫生—肿瘤]