超声引导下腹腔镜射频消融辅助治疗晚期肝癌对患者免疫功能的影响  

Study on the effect of LRFA under ultrasound guidance on immune function of patients with advanced hepatocellular carcinoma

作　　者：丁振昊[1] 蒋力[1] 张珂[1] 黄容海[1] 

机构地区：[1]首都医科大学附属北京地坛医院普通外科,北京100015

出　　处：《临床和实验医学杂志》2017年第15期1496-1499,共4页Journal of Clinical and Experimental Medicine

基　　金：首都临床特色应用研究项目(编号:Z121107001012169)

摘　　要：目的探讨超声引导下腹腔镜射频消融辅助治疗晚期肝癌对患者免疫功能的影响。方法选取2014年1月至2016年6月接受治疗的72例晚期肝癌患者作为观察对象,按数字表法分为超声引导下腹腔镜射频消融术(LRFA)辅助治疗组(观察组)和常规治疗组(对照组),每组36例。对比观察两组患者的体液免疫、细胞免疫及并发症发生情况。结果治疗前两组患者机体内的各项体液免疫指标(血清中的Ig A、Ig G及Ig M浓度)比较差异无统计学意义(P>0.05);治疗3个月后,对照组Ig A、Ig G及Ig M浓度均明显低于治疗前(P<0.05),而观察组Ig A、Ig G及Ig M浓度均明显高于治疗前(P<0.05),且观察组的各项免疫指标均显著优于对照组(P<0.05)。治疗前两组患者机体内的各项细胞免疫指标(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+及NK水平)比较差异无统计学意义(P>0.05);治疗3个月后,对照组CD3^+、CD4^+、CD4^+/CD8^+及NK的水平均明显低于治疗前(P<0.05),而CD8^+水平明显高于治疗前(P<0.05);观察组CD3^+、CD4^+、CD4^+/CD8^+及NK水平明显高于治疗前(P<0.05),而CD8^+水平明显低于治疗前(P<0.05),且观察组的各项免疫指标均显著优于对照组(P<0.05)。观察组的治疗后并发症的发生率(11.11%)显著低于对照组(38.89%),差异具有统计学意义(P<0.05)。结论在对晚期肝癌患者进行诊断和治疗时,采取超声引导下LRFA辅助治疗具有改善免疫功能、提高抗肿瘤能力及减少预后并发症的临床效果,具有较高的临床推广价值。Objective To explore the effect of laparoscopic radiofrequency ablation （ LRFA） under ultrasound guidance on the immune function in patients with advanced hepatocellular carcinoma. Methods A total of 72 patients with advanced hepatocellular carcinoma during Janu-ary 2014 to June 2016 treated in this hospital were listed for this study. They were divided into LRFA under ultrasound guidance group （observa-tion group） and routine treatment group （control group） according to the number table method, 36 cases in each group. The clinical data of hu-moral immunity, cellular immunity and prognosis of patients in these two groups, the experimental data, radiographic images and records of detail information were compared and analyzed between these 2 groups. Results The difference in indexes of humoral immunity （ serum levels of IgA, IgG and IgM） in these two groups before treatment was not significant （ P 〉 0 .0 5 ） . The serum levels of IgA, IgG and IgM in control group in 3 months after treatment were obviously lower than those before treatment, and the difference was statistically significant （ P 〈 0. 0 5 ） . The serum levels of IgA, IgG and IgM in patients of observation group in 3 months after treatment were obviously higher than those before treatment （ P 〈 0. 05） , and the immune indexes in patients of observation group were significantly better than those of control group, and the difference was statis-tically significant （ P 〈0.05） . The difference in indexes of cellular immunity （ levels of CD3 ＋ , CD4 ＋ , CD8 ＋ , CD4＋/CD8＋ and NK） in these two group before treatment was not significant （ P 〈 0. 0 5 ） . The levels of CD3 ＋ , CD4 ＋ , CD8 ＋ , CD4 ＋ /CD8 ＋ and NK in patients of ob-servation group in 3 months after treatment were obviously lower than those before treatment （ P 〈0. 05） , and the level of CD8 ＋ was obviously higher than that before treatment （ P 〈0. 0 5）

关 键 词：晚期肝癌 腹腔镜射频消融 细胞免疫 体液免疫 

分 类 号：R735.7[医药卫生—肿瘤]