微波消融术前阿霉素磁液靶向化疗治疗原发性肝癌患者疗效研究  

Preoperative doxorubicin magnetic fluid targeted chemotherapy before microwave ablation in the treatment of patients with primary liver cancer

作　　者：史浩 陈勇 罗斌 李道明[2] Shi Hao;Chen Yong;Luo Bin(Department of Radiology,People's Hospital,Liyang 213300,Jiangsu Province,China)

机构地区：[1]江苏省溧阳市人民医院放射科,213300 [2]苏州大学附属第一医院肿瘤科

出　　处：《实用肝脏病杂志》2023年第2期278-281,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:81772645)。

摘　　要：目的 研究微波消融术(MWA)前给予阿霉素磁液靶向化疗治疗原发性肝癌(PLC)患者的疗效及其血清肿瘤标记物的变化。方法 2018年1月~2021年1月我院诊治的PLC患者65例,采用随机数字表法将患者分为对照组32例和观察组33例,分别给予经皮MWA治疗或在MWA治疗前,采用Seldinger法插管至肿瘤供血动脉,给予阿霉素磁液靶向化疗。采用ELISA法检测血清糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、岩藻糖苷酶(AFU)和甲胎蛋白(AFP)水平,使用流式细胞仪检测外周血CD3+、CD4+和CD8+细胞百分比,并计算CD4+/CD8+细胞比值。结果 观察组治疗总有效率为87.9%,显著高于对照组的65.6%(P<0.05);在术后1 m,观察组血清CA19-9、CEA、AFU和AFP水平分别为(23.5±4.7)U/L、(9.3±2.1)μg/mL、(36.4±6.9)U/L和(78.5±10.2)ng/mL,显著低于对照组【分别为(31.2±5.1)U/L、(12.6±3.5)μg/mL、(45.1±10.2)U/L和(103.6±17.1)ng/mL,P<0.05】;观察组外周血CD3+和CD4+细胞百分比及CD4+/CD8+细胞比值分别为(70.5±9.1)%、(39.8±4.7)%和(1.6±0.2),显著高于对照组【分别为(61.1±8.8)%、(31.9±4.4)%和(1.4±0.1),P<0.05】。结论 在采用MWA治疗PLC患者前应用阿霉素磁液靶向化疗有助于提高近期疗效,可能与改善了细胞免疫功能紊乱有关。Objective The aim of this clinical trial was to investigate the preoperative doxorubicin magnetic fluid targeted chemotherapy before microwave ablation(MWA) in the treatment of patients with primary liver cancer(PLC). Methods 65 patients with PLC were encountered in our hospital between January 2018 and January 2021, and were randomly divided into observation(n=33) and control group(n=32). The patients in the control group was treated with percutaneous MWA, and those in the observation group was treated with preoperative doxorubicin magnetic fluid targeted chemotherapy before MWA. The clinical efficacy was evaluated by mRECIST. Serum carbohydrate antigen 19-9(CA19-9), carcinoembryonic antigen(CEA), fucosidase(AFU) and alpha-fetoprotein(AFP) levels were detected by ELISA. The percentages of peripheral blood of CD3+, CD4+and CD8+cells were detected by flow cytometry. Results The total effective rate in the observation group at one-month evaluation was 87.9%, much higher than 65.6%(P<0.05) in the control;at the end of one month after MWA, serum CA19-9, CEA, AFU and AFP levels in the observation group were(23.5±4.7)U/L,(9.3±2.1)μg/mL,(36.4±6.9)U/L and(78.5±10.2)ng/mL, all significantly lower than [(31.2±5.1)U/L,(12.6±3.5)μg/mL,(45.1±10.2)U/L and(103.6±17.1)ng/mL, respectively, P<0.05] in the control;the percentages of peripheral blood CD3+and CD4+cells as well as the ratio of CD4+/CD8+cells in the observation group were(70.5±9.1)%,(39.8±4.7)% and(1.6±0.2), all significantly higher than [(61.1±8.8)%,(31.9±4.4)% and(1.4±0.1), respectively, P<0.05] in the control. Conclusion The procedure of adriamycin magnetic fluid targeted chemotherapy before MWA in dealing with patients with PLC could promote the short-term efficacy, which might be related to the regulation of immune functions.

关 键 词：原发性肝癌 磁导向载体 阿霉素 微波消融 治疗 

分 类 号：R735.7[医药卫生—肿瘤]