经导管动脉化疗栓塞术联合微波消融治疗原发性肝细胞癌患者疗效观察  

Observation on the therapeutic effect of transcatheter arterial chemoembolization combined with microwave ablation in the treatment of primary hepatocellular carcinoma patients

作　　者：聂春生[1] 王玉峰 李士杰 侯英文 刘家[1] Nie Chunsheng;Wang Yufeng;Li Shijie;Hou Yingwen;Liu Jia(Department of Interventional,Cancer Hospital Affiliated to Harbin Medical University,Heilongjiang Province,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院介入科,150081

出　　处：《疑难病杂志》2024年第1期52-56,62,共6页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察经导管动脉化疗栓塞术(TACE)联合微波消融治疗原发性肝细胞癌(HCC)对患者血清肿瘤标志物、T淋巴细胞亚群的影响。方法收集2018年10月—2021年12月哈尔滨医科大学附属肿瘤医院介入科收治的原发性HCC患者104例临床资料,随机分为TACE组52例(TACE治疗)、联合组52例(TACE+微波消融治疗),评估术后1个月疗效,比较治疗前后2组患者肝功能指标、血清肿瘤标志物、T淋巴细胞亚群,统计患者并发症发生率。结果联合组总有效率为86.5%,高于TACE组的69.2%(χ^(2)/P=4.522/0.033);治疗后1个月联合组AST、ALT水平低于TACE组(t=10.473、8.602,P均<0.001);AFP水平低于TACE组(t=11.724,P<0.001);CD4^(+)、CD4^(+)/CD8^(+)高于TACE组,CD8^(+)低于TACE组(t=3.913、5.460、5.586,P均<0.001);2组并发症发生率比较差异无统计学意义(P>0.05)。结论原发性HCC患者接受TACE联合微波消融治疗可显著下调其血清肿瘤标志物水平,改善肝功能及免疫功能,提升整体疗效。Objective To observe the effects of transcatheter arterial chemoembolization(TACE)combined with microwave ablation on serum tumor markers and T lymphocyte subsets in patients with primary hepatocellular carcinoma(HCC).Methods Collect clinical data of 104 patients with primary HCC admitted to the Interventional Department of Harbin Medical University Affiliated Cancer Hospital from October 2018 to December 2021.They were randomly divided into a TACE group of 52 cases(TACE treatment)and a combination group of 52 cases(TACE+microwave ablation treatment).Evaluate the efficacy one month after surgery,compare the liver function indicators,serum tumor markers,and T lymphocyte subsets of the two groups before and after treatment,and calculate the incidence of patient complications.Results The total effective rate of the combined group was 86.5%,higher than the 69.2%of the TACE group(χ^(2)/P=4.522/0.033);After one month of treatment,the AST and ALT levels in the combination group were lower than those in the TACE group(t=10.473,8.602,P<0.001);The AFP level in the combination group was lower than that in the TACE group(t=11.724,P<0.001);The CD4^(+)and CD4^(+)/CD8^(+)in the combined group were higher than those in the TACE group,while CD8^(+)was lower than those in the TACE group(t=3.913,5.460,5.586,all P<0.001);There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Primary HCC patients receiving TACE combined with microwave ablation treatment can significantly reduce their serum tumor marker levels,improve liver and immune function,and enhance overall efficacy.

关 键 词：肝细胞癌 原发性 导管动脉化疗栓塞术 微波消融 肿瘤标志物 T淋巴亚群 

分 类 号：R735.7[医药卫生—肿瘤]