重组人p53腺病毒联合肝动脉栓塞化疗术治疗原发性肝癌的临床研究  

Recombinant human p53 adenovirus combined with transcatheter arterial chemoembolization in the treatment of primary liver cancer

作　　者：唐友明[1] 田洪刚[1] 张来安[2] 金江林 

机构地区：[1]四川省江油市人民医院肿瘤科,江油621700 [2]四川省江油市人民医院放射介入科,江油621700

出　　处：《中国肿瘤临床与康复》2016年第12期1424-1427,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨重组人p53腺病毒联合肝动脉栓塞化疗术对原发性肝癌治疗效果和免疫指标的影响。方法选取2014年3月至2015年3月间四川省江油市人民医院肝胆外科收治的48例原发性肝癌患者,采用随机数字表法分为研究组和对照组。研究组患者23例,采用重组人p53腺病毒注射液肝动脉灌注联合肝动脉栓塞化疗术治疗;对照组患者25例,采用单纯肝动脉栓塞化疗术治疗。评价实体瘤治疗效果,采用流式细胞术检测T细胞亚群(CD3+、CD4+、CD8+和CD4+/CD8+)指标,同时记录不良反应。结果治疗4周后对照组患者有效率(64.0%)低于研究组(91.4%),差异有统计学意义(P<0.05)。CD3+、CD4+与CD8+水平上,与治疗前1天比较,对照组和研究组治疗后不同时间段T细胞亚群表达差异有统计学意义(P<0.01),时间段与组别交互作用差异有统计学意义(P<0.01),对照组与研究组治疗后各时间段CD4+/CD8+差异无统计学意义(P>0.05)。结论重组人p53腺病毒联合肝动脉栓塞化疗术能提高原发性肝癌患者术后免疫功能,增强抗癌效果,安全有效,优于单纯肝动脉栓塞化疗术治疗。Objective To explore the effect of recombinant human p53 adenovirus combined with transcatheter arterial chemoembolization on the treatment efficacy and immune indices of primary liver cancer. Methods From March 2014 to March 2015,48 patients with primary hepatocellular carcinoma treated at Jiangyou People’s Hospital were divided into an observation group and a control group. Twenty-three patients in the observation group received hepatic arterial perfusion of recombinant human p53 adenovirus injections combined with transcatheter arterial chemoembolization（ TACE） and 25 patients in the control group received simple TACE. Using the flow cytometry,T cell subsets（ CD3＋,CD4＋,CD8＋and CD4＋/CD8＋） indicators were evaluated,and adverse reactions were recorded. Results The efficiency rate in the control group（ 64. 0%） was lower than the observation group（ 91. 4%） after 4 weeks（ P 〈 0. 05）. Compared with 1 day before treatment,there was significant difference in the expression of T cell subsets CD3＋,CD4＋and CD8＋between the observation group and the control group at different time points（ P 〈 0. 01;time points and the interactive P 〈 0. 01）. There was no statistical difference in the level of CD4＋/ CD8＋between the two groups at different time points（ P 〉 0. 05）. Conclusion Recombinant human p53 adenovirus combined with transcatheter arterial chemoembolization can improve the immune function,enhance the antitumor effect in patients with primary liver cancer,which is safe and effective,and is superior to the simple TACE treatment.

关 键 词：肝肿瘤 重组人P53腺病毒 肝动脉栓塞化疗术 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]