经肝动脉化疗栓塞术联合微波消融对中晚期肝癌细胞免疫功能和预后的影响  

The combination of transcatheter arterial chemoembolization and microwave ablation on immune function and prognosis for patients with advanced hepatocellular carcinoma

作　　者：程黎[1] 苟剑林[1] 刘燕[1] 颜朗[1] 刘定志[1] 胡大仁[1] Cheng Li;Gou Jianlin;Liu Yan;Yan Lang;Liu Dingzhi;Hu Daren(Hepatobiliary Surgery ^Chongqing Three Gorges Central Hospital ,444100 Chongqing, China)

机构地区：[1]重庆三峡中心医院肝胆外科,重庆404100

出　　处：《中国临床保健杂志》2016年第2期135-137,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨经肝动脉化疗栓塞术（TACE)联合微波消融（MVA)对中晚期肝癌细胞免疫功能和预后的影响。方法回顾性分析96例中晚期肝癌患者资料，其中55例行TACE联合MVA治疗（联合组），41例行单纯TACE治疗（对照组）。比较两组患者术后CD4+、CD8+T淋巴细胞、NK细胞水平和生存情况。结果与治疗前比较，对照组术后3种免疫指标无明显变化（均P>0.05),而联合组术后CD4+T淋巴细胞和NK细胞比例逐渐上升,CD8+T淋巴细胞比例下降，其中治疗后1个月3种免疫指标较术前，差异有统计学意义（均P<0.05)。联合组治疗后1月CD4+淋巴细胞和NK细胞比例高于对照组，CD8+淋巴细胞比例低于对照组，且差异均有统计学意义（均P<0.05)。随访时间为5.5~43.6个月。联合组1年、2年、3年总生存率分别为83.6%、52.7%、9.1%;对照组1年、2年、3年总生存率分别为70.7%、14.6%、0。两组患者的总生存率比较，差异有统计学意义（P=0.001)。结论较单纯TACE治疗，TACE联合MVA治疗可以改善中晚期肝癌患者的细胞免疫功能和生存情况。Objective To explore the impact of transcatheter arterial chemoembolization combined (TACE)with microwave ablation (MWA) on immune function and prognosis of patients with advanced hepatocellular carcinoma.Methods 96 cases with advanced hepatocellular carcinoma were reviewed. They were divided into combined group(n = 5 5 ) underwent TACE combined with MVA and control group underwent TACE (n = 4 CD8 + T and NK cells and survival rate were compared. Results In the control group, no difference in the threeimmunity index were observed between preoperative and postoperative (all P > 0 .0 5 ). In the combined of CD4 + T and NK cells were increased and CD8 + T cells was reduced. There were statistical difference in the threeimmunity index between preoperative and postoperative 1 month (all P < 0 .0 5 ). But in the CD4 + T and NK cells were higher and CD8+ T cells were lower compared with those in the control group (allP <0. 05). The follow - up period ranged from 5.5 to 43. 6 months (20. 9 ± 2. 3 ) .The 1 - ,2 - , and 3 - year overallsurvival rate in the proximal group were 83. 6% ,52. 7% and 9. 1% respectively. However the 1 - ,2 - ,and 3 - yearoverall survival rate in the total group were 70. 7% ,14. 6% and 0, respectively. There was a overall survival between the two groups ( P = 0. 001 ). Conclusions TACE combined with MVA for advancedhepatocellular carcinoma can improve the immune function and overall survival rate compared with TACE

关 键 词：肝肿瘤 化学栓塞 治疗性 消融技术 免疫系统现象 

分 类 号：R735.7[医药卫生—肿瘤]