经导管动脉化疗栓塞术联合超声引导射频消融术治疗原发性肝癌对疗效及免疫功能的影响  

The effect of transcatheter arterial chemoembolization combined with ultrasound-guided radiofrequency ablation on the efficacy and immune function in patients with primary liver cancer

作　　者：武文华[1] 冯秦辉 蔡芝芳[1] 贾晓黎[1] 杨锐华[3] 党双锁[1] Wu Wenhua;Feng Qinhui;Cai Zhifang;Jia Xiaoli;Yang Ruihua;Dang Shuangsuo(Department of Infectious Diseases,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China;Department of Infectious Diseases,the Second Affiliated Hospital of Air Force Military Medical University,Xi′an;Department of Clinical Laboratory,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,Chin)

机构地区：[1]西安交通大学第二附属医院感染科,西安710004 [2]空军军医大学第二附属医院传染科,西安710038 [3]西安交通大学第二附属医院检验科,西安710004

出　　处：《中国医师进修杂志》2022年第5期459-464,共6页Chinese Journal of Postgraduates of Medicine

基　　金：西安交通大学第二附属医院科研基金自由探索项目(2020YJ(ZYTS)236)。

摘　　要：目的探讨经导管动脉化疗栓塞术(TACE)联合超声引导射频消融术(RFA)治疗原发性肝癌的疗效及对免疫功能的影响。方法回顾性分析2019年2月至2021年2月西安交通大学第二附属医院收治的152例原发性肝癌患者的临床资料。其中,行TACE联合RFA治疗76例(联合组),仅行TACE治疗76例(对照组)。比较两组疗效;分别于治疗前和治疗后1个月检测α-L岩藻糖苷酶、T淋巴细胞亚群(CD_(3)、CD_(4)、CD_(8)和CD_(4)/CD_(8))、B淋巴细胞亚群(CD_(19))和肿瘤标志物[甲胎蛋白(AFP)、癌胚抗原(CEA)和糖类抗原125(CA_(125))]。结果联合组总有效率明显高于对照组[81.58%(62/76)比52.63%(40/76)],差异有统计学意义(χ^(2)=4.54,P<0.05)。两组治疗前各指标比较差异无统计学意义(P>0.05);联合组治疗后1个月α-L岩藻糖苷酶、AFP和CD_(8)明显低于对照组[(18.06±5.33)U/L比(26.58±7.75)U/L、(87.93±22.55)μg/L比(146.83±21.85)μg/L和0.295±0.052比0.367±0.064],CD_(3)、CD_(4)和CD_(4)/CD_(8)明显高于对照组(0.489±0.054比0.462±0.063、0.363±0.059比0.303±0.075和1.43±0.27比0.89±0.14),差异有统计学意义(P<0.01或<0.05);两组治疗后1个月CEA、CA_(125)、CD_(19)比较差异无统计学意义(P>0.05)。结论TACE联合RFA治疗原发性肝癌患者不仅能够提高总有效率,还可以改善免疫功能和降低血清肝肿瘤标志物AFP水平。Objective To investigate the effect of transcatheter arterial chemoembolization(TACE)combined with ultrasound-guided radiofrequency ablation(RFA)on the efficacy and immune function in patients with primary liver cancer.Methods The clinical data of 152 patients with primary liver cancer from February 2019 to February 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed.Among them,76 patients were treated with TACE combined with RFA(combined group),and 76 patients were treated with TACE(control group).The efficacy was compared;theα-L fucosidase,T lymphocyte subsets(CD_(3),CD_(4),CD_(8) and CD_(4)/CD_(8)),B lymphocyte subsets(CD_(19))and tumor markers(alpha-fetoprotein,AFP;carcinoembryonic antigen,CEA;carbohydrate antigen 125,CA_(125))before treatment and 1 month after treatment were detected.Results The total clinical effective rate in combined group was significantly higher than that in control group:81.58%(62/76)vs.52.63%(40/76),and there was statistical difference(χ^(2)=4.54,P<0.05).There were no statistical difference in all indexes before treatment between 2 groups(P>0.05);theα-L fucosidase,AFP and CD_(8)1 month after treatment in combined group were significantly lower than those in control group:(18.06±5.33)U/L vs.(26.58±7.75)U/L,(87.93±22.55)μg/L vs.(146.83±21.85)μg/L and 0.295±0.052 vs.0.367±0.064,the CD_(3),CD_(4) and CD_(4)/CD_(8) were significantly higher than those in control group(0.489±0.054 vs.0.462±0.063,0.363±0.059 vs.0.303±0.075 and 1.43±0.27 vs.0.89±0.14),and there were statistical differences(P<0.01 or<0.05);there was no statistical difference in CEA,CA_(125) and CD_(19)1 month after treatment between 2 groups(P>0.05).Conclusions TACE combined with RFA in the treatment of primary liver cancer patients can not only improve the total clinical effective rate,but also significantly improve the immune function,and help to reduce level of the liver tumor marker of AFP.

关 键 词：肝肿瘤 肝动脉 栓塞 治疗性 射频消蚀 超声检查 回顾性研究 

分 类 号：R735.7[医药卫生—肿瘤]