TACE联合重组人p53腺病毒治疗对原发性肝癌患者免疫应答及预后的影响  

Effect of TACE combined with recombinant human p53 adenovirus on immune response and prognosis in patients with primary liver cancer

作　　者：赵文菊 ZHAO Wenju(Department of Oncology,the People's Hospital of Longevity District,Chongqing 401220,China)

机构地区：[1]重庆市长寿区人民医院肿瘤科,重庆401220

出　　处：《现代肿瘤医学》2021年第19期3425-3430,共6页Journal of Modern Oncology

摘　　要：目的:探讨TACE联合重组人p53腺病毒治疗对原发性肝癌患者免疫应答及预后的影响。方法:选取我院于2016年01月至2017年12月收治的60例中晚期原发性肝癌患者作为研究对象,分为对照组和研究组,每组30例。对照组采取经导管肝动脉化疗栓塞术(TACE)治疗,研究组在对照组基础上联合重组人p53腺病毒注射液治疗。比较两组患者近期临床疗效、两组患者治疗后1年存活率、生活质量情况,比较两组患者术前1天、术后1周、术后2周、术后4周的外周血免疫细胞水平以及甲胎蛋白(AFP)水平,同时观测两组患者治疗期间不良反应发生情况。结果:研究组近期临床治疗总有效率60.00%(18/30)显著高于对照组33.33%(10/30);两组患者治疗后1周各免疫细胞水平与治疗前相比无明显差异(P>0.05),但治疗2周和4周后两组患者CD8^(+)水平均显著下降,CD3^(+)、CD4^(+)水平以及CD4^(+)/CD8^(+)比值显著上升,且研究组改善程度显著优于对照组(P<0.05);研究组患者甲胎蛋白(AFP)水平相比对照组下降更明显(P<0.05);治疗期间研究组不良反应发生率20.00%与对照组16.67%相比,差异无统计学意义(P>0.05);对两组患者1年生存随访,结果显示研究组死亡3例,存活27例,对照组死亡10例,存活20例,两组生存期差异存在显著意义(log-rank P=0.030);且研究组半年后和1年后生活质量改善程度显著优于对照组(P<0.05)。结论:TACE基础上联合重组人p53腺病毒可以显著改善原发性肝癌患者免疫细胞水平和机体免疫应答功能,提高1年生存率以及改善患者预后。Objective:To investigate the effect of TACE combined with recombinant human p53 adenovirus on immune response and prognosis in patients with primary liver cancer.Methods:Sixty patients with advanced hepatocellular carcinoma who were admitted to our hospital from January 2016 to December 2017 were enrolled in the study.They were divided into study group and control group(30 patients in each group).The control group was treated with transcatheter arterial chemoembolization(TACE).The study group was treated with recombinant human p53 adenovirus injection on the basis of the control group.The short-term clinical efficacy of the two groups of patients,the one-year survival rate and quality of life of the two groups of patients were compared.The levels of immune cells and alpha-fetoprotein(AFP)levels of the peripheral blood of the two groups before surgery,1 day after surgery,2 weeks after surgery,and 4 weeks after surgery were compared,and adverse events during treatment were compared between the two groups.Results:After the treatment group was treated with recombinant human p53 adenovirus combined with TACE,the total effective rate of recent clinical treatment in the study group was 60.00%(18/30),which was significantly higher than that in the control group was 33.33%(10/30)(P<0.05).After treatment,there was no significant difference in the levels of immune cells between the two groups after treatment(P<0.05),but the levels of immune cells were significantly improved at 2 weeks after treatment and 4 weeks after treatment.One year of follow-up of the two groups of patients,the results showed that the study group died 3 people,27 patients survived,the control group died 10 people,surviving 20 people,the difference in survival between the two groups was significant(log-rank P=0.030).The quality of life of the study group was significantly improved compared with the control group after half a year and one year after treatment(P<0.05).After treatment,the levels of alpha-fetoprotein(AFP)in the two groups were significantly

关 键 词：重组人P53腺病毒 肝动脉化疗栓塞术 原发性肝癌 免疫应答 预后 

分 类 号：R735.7[医药卫生—肿瘤]