超声引导下经皮微波消融治疗原发性肝癌患者疗效分析  

Ultrasound-guided percutaneous microwave ablation and thymosin α-1 treatment in patients with primary liver cancer

作　　者：柏涛[1] 龚凤云[1] 胡旭东[1] 王娟[1] 夏冰[1] 程海林[1] 甘丽娟 

机构地区：[1]武汉市金银潭医院(原武汉市医疗救治中心)肝病科,430023

出　　处：《实用肝脏病杂志》2018年第1期84-87,共4页Journal of Practical Hepatology

基　　金：武汉市卫生与计划生育委员会科研课题(编号:WX12D24)

摘　　要：目的探讨超声引导下经皮微波消融联合胸腺素-α1治疗原发性肝癌(PLC)患者的疗效。方法 2011年3月~2013年3月我院收治的PLC患者104例,随机分为观察组52例和对照组52例。对照组采用超声引导下经皮微波消融术治疗,观察组于术后皮下注射胸腺素-α1 4周。比较治疗前和治疗后外周血T淋巴细胞亚群、肝功能、甲胎蛋白(AFP)水平变化和两组肿瘤复发或转移及3年生存情况。结果在治疗4周时,观察组外周血CD3^+、CD4^+、CD4^+/CD8^+比值分别为71.49±6.57%、43.12±2.89%、15.89±3.24,显著高于对照组的43.21±3.74%、24.56±2.36%、5.42±2.13(P<0.05);观察组血清白蛋白(ALB)为39.84±2.56 g/L,显著高于对照组的34.12±1.87 g/L,丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、AFP水平分别为34.87±3.08 U/L、43.39±2.08 U/L、85.42±10.42μg/L,显著低于对照组的61.39±3.64 U/L、56.74±3.46 U/L、164.29±14.35μg/L;随访3年,观察组肿瘤复发率和转移率分别为30.8%和15.4%,显著低于对照组的50.0%和32.7%(P<0.05),观察组生存率为23.1%(12/52),显著高于对照组的5.8%(3/52,P<0.05)。结论超声引导下经皮微波消融后继续接受α-1胸腺素治疗PLC患者效果显著,可降低肿瘤复发或转移,延长生存时间,值得研究。Objective To investigate the efficacy of ultrasound-guided percutaneous microwave ablation and thymosin α-1 treatment in patients with primary liver cancer （PLC）. Methods A total of 104 patients with PLC were admitted to our hospital between March 2011 and March 2013 and they were randomly divided into observation group （n=52） and control group （n=52）. The patients in control group were treated with ultrasound- guided percutaneous microwave ablation,and the ones in observation group were given subcutaneously with thymosin-al. Results At the end of 4 week treatment,the CD3＋ and CD4＋ cells and the ratio of CD4＋/CD8＋ were 71.49±6.57%,43.12±2.89% and 15.89±0.24,significantly higher than 43.21±3.74%,24.56±2.36% and 5,42± 2.13 in the control （P〈0.05）;the liver function index and serum alpha-fetoprotein levels in the observation group improved or decreased significantly than in the control （P〈0.05）;the complication occurrence in the observation group was 7.7% ,not statistically significantly different with 11.5% in the control （P〉0.05）;all patients were followed-up for 3 years,and the recurrence and metastasis in the observation group were 30.8% and 15.4%,much lower than 50.0% and 32.7% in the control （P〈0.05）;the 3 a survival rate in the observation group was 23.1% （12/52）,much higher than 5.8% （3/52,P〈0.05） in the control group. Conclusion Ultrasound-guided percutaneous microwave ablation followed by thymosin-al injection in the treatment of patients with PLC is efficient, with lower recurrence and metastasis and prolongation of survival ,which warrants further investigation.

关 键 词：原发性肝癌 经皮微波消融 胸腺素-α1 治疗 复发/转移 

分 类 号：R735.7[医药卫生—肿瘤]