单纯TACE与联合肿瘤间质治疗对肝癌患者免疫球蛋白、补体和T细胞亚群的影响  

The effect of TACE combined with interstitial therapy on immune globulin,complement and T cell in patients with liver cancer

作　　者：李步天 章盛平[1] 

机构地区：[1]上海市静安区中心医院(复旦大学附属华山医院静安分院)普外科,上海200040

出　　处：《海南医学院学报》2016年第16期1863-1865,1869,共4页Journal of Hainan Medical University

基　　金：上海市卫生厅自筹经费科研课题(Z2013281)~~

摘　　要：目的:探讨单纯经肝动脉化疗栓塞(TACE)与联合肿瘤间质治疗肝癌临床疗效,及对患者免疫球蛋白、补体和T细胞亚群的影响。方法:选取2013年3月~2015年4月医院收治的95例肝癌患者为研究对象,随机分为A组(n=47)和B组(n=48),A组行单纯TACE治疗,B组行TACE^+肿瘤间质治疗(经皮肝瘤内注射碘油化疗药物),术前1周与术后4周取外周血,观察两组免疫球蛋白、补体和T细胞亚群变化。结果 :术后碘油沉积率、肿瘤缩小率、局控率B组明显高于A组,有统计学差异(t=13.306、4.132,χ~2=6.996,P<0.05);与治疗前比较,治疗后两组CD3^+、CD4^+、CD4^+/CD8^+均显著升高,CD8^+明显降低(P<0.05),治疗后CD3^+、CD4^+、CD4^+/CD8^+、CD8^+两组之间比较有统计学差异(P<0.05);治疗后A组免疫球蛋白及补体水平升高,但无统计学差异(P>0.05),B组免疫球蛋白及补体水平有显著改善(P<0.05),治疗后免疫球蛋白及补体水平两组比较有统计学差异(P<0.05)。结论:单纯TACE治疗肝癌可增强细胞免疫功能,对体液免疫影响较小,TACE与肿瘤间质联合应用于肝癌患者可对患者细胞免疫和体液免疫有着显著改善,有利于患者预后。Objective： To explore the effect of TACE combined with interstitial therapy on immune globulin,complement and T lymphocyte subsets in patients with liver cancer. Methods： A total of 95 patients with liver cancer from March 2013 to April 2015 in the hospital were selected,and they were randomly divided into group A（ n = 47） and group B（ n = 48）,patients in group A were given simple TACE treatment,while patients in group B underwent TACE ~＋ tumor interstitial therapy（ percutaneous liver tumor injection of lipiodol chemotherapy）. Immune globulin,complement and T lymphocyte subsets in peripheral blood preoperative 1w and postoperative 4w were observed. Results： After treatment,the lipiodol deposition rate,local control rate and tumor reduction rate of group B were significantly higher than that in group A,which had statistically significant difference between the two groups（ t = 13. 306,4.132,χ~2= 6. 996,P〈0. 05）. Compared with that before treatment,CD3~＋,CD4~＋,CD4~＋/ CD8~＋were significantly increased,CD8~＋was significantly decreased after treatment（ P〈0. 05）. There were significantly differences in CD3~＋,CD4~＋,CD4~＋/ CD8~＋,CD8~＋between the two groups after treatment（ P〈0. 05）. The immune globulin and complement levels increased in group A after treatment,but had no significant difference（ P〉0. 05）. Immunoglobulin and complement levels increased significantly in group B（ P〈0. 05）,there were significantly differences in immunoglobulin and complement levels in the two groups after treatment（ P〈0. 05）. Conclusions： The results showed that single TACE treatment in patients with liver cancer could enhance immune function,which had little effect on the humoral immunity. TACE combined with interstitial therapy could improve patients＇ cellular immunity and humoral immunity,which was benefit for prognosis.

关 键 词：肝癌 补体 免疫球蛋白 T淋巴细胞 

分 类 号：R735.7[医药卫生—肿瘤]