超声引导下微波消融对复发性肝癌患者免疫功能及生存时间的影响  

Effects of ultrasound-guided microwave ablation on the immune function and survival time in patients with recurrent liver cancer

作　　者：崔姗姗 蒋玲玲[1] 姚志勇[2] CUI Shan-shan;JIANG Ling-ling;YAO Zhi-yong(Department of Ultrasound,Jiangsu Second Hospital of Traditional Chinese Medicine,Nanjing 210017,China;Department of Ultrasound,Mingji Hospital Affiliated to Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]江苏省第二中医院超声科,南京210017 [2]南京医科大学附属明基医院超声科,南京210019

出　　处：《中国肿瘤临床与康复》2020年第8期937-940,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨超声引导下微波消融对复发性肝癌患者免疫功能及生存时间的影响。方法选取2015年8月至2017年6月间江苏省第二中医院和南京明基医院收治的122例复发性肝癌患者,根据复发时间进行分组,复发≤1年为早期复发组62例,复发> 1年为晚期复发组60例。两组患者均行超声引导下微波消融术治疗,比较两组患者治疗后免疫功能,采用Cox回归分析影响患者生存时间的危险因素。结果治疗后,早期复发组患者Ig G和Ig M均低于晚期复发组,Ig A高于晚期复发组,差异均有统计学意义(P <0.05)。两组患者饮酒、甲胎蛋白、肿瘤位于肝脏包膜下、肿瘤边界是否规整、肿瘤距大血管≤1cm、复发时间和随访生存时间比较,差异均有统计学意义(均P <0.05)。Cox分析结果显示,肿瘤位于肝脏包膜下、肿瘤边界是否规整和复发时间是影响肝癌复发患者微波消融术后生存时间的独立危险因素。早期复发组患者至随访结束存活14例,死亡48例,晚期复发组存活41例,死亡19例,两组比较,差异有统计学意义(x^2=25.78,P <0.05)。结论不同复发时间段肝癌患者行超声引导下微波消融治疗,均会影响患者免疫功能,早期复发者影响较大;肿瘤位于肝脏包膜下、肿瘤边界是否规整和复发时间是影响患者生存时间的独立危险因素。Objective To analyze the effects of ultrasound-guided microwave ablation on immune function and survival time in patients with recurrent liver cancer. Methods A total of 122 patients with recurrent liver cancer treated at Jiangsu Second Hospital of Traditional Chinese Medicine and Mingji Hospital Affiliated to Nanjing Medical University were selected from August 2015 to June 2017 as the subjects. They were divided into two groups based on the recurrence time. The patients with recurrence ≤ 1 year were included in an early recurrence group( 62 patients) and patients whose recurrence occurred > 1 year were included in a late recurrence group( 60 patients). The patients in both groups underwent ultrasound-guided microwave ablation. The immune function after treatment was compared between the two groups. Cox regression analysis was used to analyze the risk factors influencing the survival time. Results The Ig G and Ig M were significantly lower in the early recurrence group than in the late recurrence group,and the Ig A was significantly higher in the early recurrence group than in the late recurrence group( all P < 0. 05). There were significant difference in alpha-fetoprotein,location of tumors under the liver capsule,whether the tumor boundary was regular,the distance between the tumor and the macro vessel ≤ 1 cm,recurrence time and the survival time between the two groups( all P < 0. 05). The results of Cox analysis showed that the tumor was located under the liver capsule,whether the tumor boundary was regular or not,and the recurrence time were independent risk factors influencing the survival time in patients with recurrent liver cancer after microwave ablation( all P < 0. 05). At the end of follow-up,14 patients survived and 48 patients died in the early recurrence group,and 41 patients survived and 19 patients died in the late recurrence group( all P <0. 05). Conclusion Microwave ablation guided by ultrasound may affect immune function in patients with recurrent liver cancer irregardless of time of occur

关 键 词：超声引导 微波消融 复发性肝肿瘤 免疫功能 生存时间 

分 类 号：R735.7[医药卫生—肿瘤]