AAL细胞联合手术及介入治疗原发性肝癌临床观察  

Clinical observation of AAL combined with surgery and interventional treatment for primary hepatocellular carcinoma

作　　者：伍慧丽[1] 鲍旭丽[1] 张蕾[1] 李宁[2] 闾军[1] WU Hui-li;BAO Xu-li;ZHANG Lei;LI Ning;LV Jun(Department of Liver and Tumor Biotherapy,Beijing YouAn Hospital, Capital Medical University,Beijing 100069, China;Department of Hepatobiliary Surgery, Beijing YouAn Hospital, Capital Medical University,Beijing 100069, China)

机构地区：[1]首都医科大学附属北京佑安医院肝病与肿瘤生物治疗科,北京100069 [2]首都医科大学附属北京佑安医院肝胆外科,北京100069

出　　处：《肝胆胰外科杂志》2017年第4期265-270,275,共7页Journal of Hepatopancreatobiliary Surgery

基　　金：北京市卫生系统高层次卫生技术人才培训项目(2011-2-20);佑安肝病艾滋病基金项目(20150306)

摘　　要：目的评估活化自体淋巴细胞(activated autologous lymphocyte,AAL)联合手术及介入治疗对原发性肝癌患者生存期及预后的影响。方法回顾性分析2013年1月至2016年2月期间首都医科大学附属北京佑安医院肝病与肿瘤生物治疗科收治的297例经手术及介入治疗原发性肝癌患者,分为联合AAL治疗的观察组(146例)以及未联合AAL治疗的对照组(151例),收集患者临床资料、实验室数据及随访情况,采用Kaplan-Meier法比较两组患者平均疾病进展时间(time to progression,TTP)和总生存期(overall survival,OS),采用寿命表法比较两组不同时期疾病(无)进展率及病死率,采用Kaplan-Meier单因素分析和Cox比例风险模型多因素分析影响TTP和OS的相关因素。结果观察组和对照组中位TTP和OS分别为(10.0个月vs 5.0个月,P=0.017)、(16.0个月vs 11.0个月,P=0.014),观察组较对照组疾病进展率和病死率降低11.1%(81.5%vs 92.6%,P=0.009)和16.5%(53.2%vs 69.7%,P=0.008)。影响患者TTP和OS的因素包括:接受AAL免疫治疗、年龄≥65岁、巴塞罗那肝癌分期为A^B期、无肝硬化或肝硬化Child-Pugh A级。结论原发性肝癌患者接受AAL联合手术和介入治疗可以延缓疾病进展时间和延长生存期,降低疾病进展率和病死率,改善总体预后。Objective To assess the influence of activated autologous lymphocyte(AAL)combined with surgeryand interventional treatment on survival time and prognosis of primary hepatocellular carcinoma.MethodsA total of297primary hepatocellular carcinoma patients were collected between Jan.2013and Feb.2016andwere divided into observation group(146,with AAL treatment)and control group(151,without AAL treatment).Based on patients clinical documents,lab data and follow-up visits,the time to progression(TTP)and overallsurvival(OS)between the two groups were compared by Kaplan-Meier analysis.Influential factors of TTP andOS on the all297patients were analyzed by Kaplan-Meier univariate analysis and Cox multivariate analysis.Results The median TTP and OS in the observation group and the control group were10.0month vs5.0month,16.0month vs11.0month(with P=0.017,P=0.014,respectively);the observation group had a significantly decreaseof its overall disease developing rates and overall death rate by11.1%(81.5%vs92.6%,P=0.009)and16.5%(53.2%vs69.7%,P=0.008).Factors influencing TTP and OS included:receiving AAL immune treatment,age over65,Barcelona liver cancer dividing into A and B stage,having liver cirrhosis Child-Pugh A level or nocirrhosis.Conclusion For primary hepatocellular carcinoma patients,AAL combined with surgery and interventionaltreatment will slow the disease developing time and prolong survival time,decrease disease developingrates and death rates,and improve the overall prognosis.

关 键 词：原发性肝癌 过继性细胞免疫治疗 生存期 预后 

分 类 号：R735.7[医药卫生—肿瘤]