微波消融联合DEB-TACE对中晚期肝癌患者免疫功能及预后的影响研究  

Effect of microwave ablation combined with DEB-TACE on immune function and prognosis of patients with advanced hepatocellular carcinoma

作　　者：李海霞 王秀香 郭琳 柴梅 李媛媛 高爱华 宋兆伟[4] LI Hai-xia;WANG Xiu-xiang;GUO Lin;CHAI Mei;LI Yuan-yuan;GAO Ai-hua;SONG Zhao-wei(Department of Radiological Intervention,Cangzhou Third Hospital,Hebei 061001,China;Department of CT,Cangzhou Third Hospital,Hebei 061001,China;Department of Hepatology,Cangzhou Third Hospital,Hebei 061001,China;Department of Radiological Intervention,Cangzhou Central Hospital,Hebei 061011,China)

机构地区：[1]沧州市第三医院放射介入科,河北061001 [2]沧州市第三医院CT室,河北061001 [3]沧州市第三医院肝病科,河北061001 [4]沧州市中心医院放射介入科

出　　处：《肝脏》2023年第4期465-468,共4页Chinese Hepatology

基　　金：中国健康促进基金会影像介入科研基金项目(XM_2020_011_0255_01)。

摘　　要：目的探讨微波消融(MWA)联合载药栓塞微球经肝动脉化疗栓塞(DEB-TACE)对中晚期肝癌患者预后及免疫功能的影响。方法选取2020年4月-2021年9月沧州市第三医院收治的中晚期肝癌70例,单双色号法分成观察组(DEB-TACE联合MWA,n=35)与对照组(TACE联合MWA,n=35)。对比2组血清指标、临床疗效、免疫功能及并发症。结果治疗4周后,观察组甲胎蛋白(AFP)(65.23±9.18)ng/mL、白蛋白(Alb)(33.26±2.61)g/L、天冬氨酸氨基转移酶(AST)(44.24±4.14)μmol/L、总胆红素(TBil)(24.97±4.25)μmol/L明显低于对照组AFP(123.38±13.46)ng/mL、Alb(36.46±2.93)g/L、AST(49.17±5.23)μmol/L、TBil(31.15±5.13)μmol/L(P<0.05)。治疗8周后,观察组CD4+为(43.51±9.29)%、明显高于对照组的(33.72±8.31)%(P<0.05);观察组CD8+(24.29±3.35)%,明显低于对照组的(27.14±4.21)%(P<0.05)。观察组总有效率为(85.71%),明显高于对照组的(57.14%)(P<0.05)。2组并发症发生率相比差异无统计学意义(P>0.05)。结论中晚期肝癌采用MWA联合DEB-TACE治疗疗效显著确切,可降低AFP水平,改善患者的肝功能,且安全可靠。Objective To investigate the effects of microwave ablation(MWA)combined with drug-eluting beads(DEB)-transcatheter arterial chemoembolization(TACE)on the prognosis and immune function of patients with advanced hepatocellular carcinoma(HCC).Methods A total of 70 patients with advanced HCC admitted to the hospital from April 2020 to September 2021 were divided into observation group(DEB-TACE combined with MWA,n=35)and control group(TACE combined with MWA,n=35).The two groups of serum indexes,clinical efficacy,immune function and complications were compared.Results The serum levels of Alpha-fetoprotein(AFP),albumin(Alb)aspartate aminotransferase(AST)and total bilirubin(TBil)in the observation group were significantly lower than the control group after 4 weeks of treatment[(65.23±9.18)ng/mL vs.(123.38±13.46)ng/mL,(33.26±2.61)g/L vs.(36.46±2.93)g/L,(44.24±4.14)μmol/L vs.(49.17±5.23)μmol/L,(24.97±4.25)μmol/L vs.(31.15±5.13)μmol/L,all P<0.05].After 8 weeks of treatment,CD4+in the observation group was,significantly higher than control group[(43.51±9.29)%vs.(33.72±8.31)%,(P<0.05)],contrary to CD8+[(24.29±3.35)%vs.(27.14±4.21)%,P<0.05].The total effective rate in the observation group was higher than the control group[(85.71%)vs.(57.14%),P<0.05].Between the two groups,there was no difference in the incidence of complications(P>0.05).Conclusion MWA combined with DEB-TACE has a significant and definite curative effect in advanced HCC.Meanwhile,it could also reduce the serum AFP level and improve liver function in patients,which is safe and reliable.

关 键 词：中晚期肝癌 载药栓塞微球经肝动脉化疗栓塞 微波消融 免疫功能 预后 

分 类 号：R735.7[医药卫生—肿瘤]