射频消融联合肝动脉化疗栓塞对大肝癌患者机体抗肿瘤免疫状态的影响  

Effect of radiofrequency ablation combined transcatheter arterial chemoembolization on antitumor immune status of patients with hepatocellular carcinoma

作　　者：朱德东[1] 石小军[1] 王哲 袁登高 蔡挺 张顺 ZHU De-dong;SHI Xiao-jun;WANG Zhe;et al(Hepatology Department of the Second Hospital of Ningbo, Ningbo, Zhejiang 315000, China)

机构地区：[1]宁波市第二医院肝肿瘤科,浙江宁波315000 [2]宁波大学医学院预防医学学科系,浙江宁波315211

出　　处：《中华全科医学》2018年第1期38-40,79,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金(LY15H160046)

摘　　要：目的探讨射频消融联合肝动脉化疗栓塞对大肝癌患者机体抗肿瘤免疫状态的影响。方法采用随机数字法将186例大肝癌患者分为对照组与观察组,每组93例。对照组行经导管肝动脉化疗栓塞(TACE)治疗,观察组在对照组基础上联合射频消融术(RFA)治疗。治疗后,比较2组血清肿瘤活性因子[甲胎蛋白(AFP)、基质金属蛋白酶(MMP)、CA199]、T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)、免疫球蛋白(Ig A、Ig M、Ig G)水平的变化以及患者生活质量与近期疗效。结果治疗前,2组AFP、MMP、CA199水平差异无统计学意义(P>0.05);治疗后,2组AFP、MMP、CA199水平均显著下降(P<0.05),且观察组下降幅度明显高于对照组(P<0.05)。治疗前,2组CD3^+、CD4^+、CD8^+、CD4^+/CD8^+差异无统计学意义(P>0.05);治疗后,2组CD3^+、CD4^+、CD8^+、CD4^+/CD8^+改善明显(P<0.05),观察组改善程度优于对照组(P<0.05)。治疗前,2组Ig A、Ig G、Ig M差异无统计学意义(P>0.05);治疗后,2组Ig G、Ig M均明显升高(P<0.05),且观察组升高幅度高于对照组(P<0.05)。与对照组比较,观察组治疗后的躯体功能、症状/不良作用及社会功能评分更高(P<0.05)。治疗后,观察组近期整体疗效明显优于对照组(P<0.05)。结论射频消融联合肝动脉化疗栓塞可明显降低大肝癌患者肿瘤活性因子水平,增强患者机体抗肿瘤免疫功能,提高患者的生活质量。Objective To investigate the effect of radiofrequency ablation combined transeatheter arterial chemoembolization on the anti-tumor immune status of patients with hepatocellular carcinoma. Methods A total of 186 patients with hepatocellular carcinoma were divided into control group and observation group by random number method. The control group was treated with TACE and the observation group was treated with RFA based on control group. After treatment, the serum tumor activating factor （AFP, MMP and CA199） , T lymphocyte subsets （ CD3 ＋ , CD4 ＋ , CD8 ＋ and CD4 ＋ / CD8 ＋ ） , immunoglobulin（ IgA, IgM and IgG） , life quality and short-term efficacy of two groups were compared. Results Before treatment, AFP, MMP and CA199 levels of two groups were no significantly different （P 〉0.05） ; after treatment, the AFP, MMP and CA199 levels of two groups were significantly decreased （P 〈 0.05） , and the decrease rate of observation group was higher （P 〈 0.05）. Before treatment, the CD3 ＋ , CD4 ＋ , CD8 ＋ and CD4 ＋/CD8 ＋ levels of two groups were no significantly different （ P 〉 0.05 ） ; after treatment the CD3 ＋ , CD4＋ , CD8 ＋ , CD4＋/CD8 ＋ levels of two groups were significantly improved （ P 〉 0.05 ） ; and the improvement of observation group was higher than control group （P 〈 0.05）. Before treatment, IgA, IgG and IgM of two groups were no significantly different （P 〉 0.05）. After treatment, IgG and IgM of two groups were significantly increased （ P 〈 0.05 ） , and the improvement of observation group was higher than control group （ P 〈 0.05 ）. Compared with control group, the body function, symptom / adverse effect and social function score of observation group were higher （ P 〈 0.05 ）. After treatment, the overall effect of the observation group was significantly better than control group （ P 〈 0.05 ）. After treatment, IgG and IgM were significantly higher than those in lgA （ P 〈 0.05 ） Control group （P 〈 0.0

关 键 词：大肝癌 射频消融 肝动脉化疗栓塞 免疫功能 

分 类 号：R735.7[医药卫生—肿瘤] R730.58[医药卫生—临床医学]