腹腔镜下射频消融术治疗原发性肝癌的效果探讨

目的:探讨腹腔镜下射频消融术(laparoscopic radiofrequency ablation,LRFA)治疗原发性肝癌的临床效果及对患者血清甲胎蛋白(alpha-fetoprotein,AFP)、干扰素-γ(interferon-γ,IFN-γ)及细胞免疫水平的影响。方法:选取2011年1月至2013年1月治疗的60例原发性肝癌患者,其中30例行LRFA(LRFA组),30例行传统手术(传统组),对比两组临床效果。结果:术后复查,LRFA组肿瘤完全坏死率86.67%、肿瘤不完全坏死率10.00%、肿瘤部分坏死率3.33%,传统组术后复查,均成功切除病灶。治疗前、治疗后2周、治疗后4周,两组患者血清AFP水平差异无统计学意义(P>0.05);治疗后2周、治疗后4周,LRFA组血清IFN-γ、CD3~+、CD4~+、CD4~+/CD8~+水平高于传统组(P<0.05);LRFA组2年生存率(50.00%)高于传统组的23.33%(P<0.05)。结论:LRFA治疗原发性肝癌的临床疗效与传统手术相当,并能改善患者的早期免疫学指标。

Effect of laparoscopic radiofrequency ablation on primary hepatic carcinoma

Objective:To investigate the clinical effect of laparoscopic radiofrequency ablation ( LRFA) in the treatment of pa-tients with primary liver cancer and its effect on the levels of serum alpha-fetoprotein ( AFP) ,interferon-γ( IFN-γ) and cellular immu-nity.Methods:Clinical data of 60 patients with primary liver cancer from Jan .2011 to Jan.2013 were retrospectively studied .Among them,30 patients underwent LRFA (LRFA group) and 30 patients underwent traditional surgical treatment (traditional group).The clinical effect of the two methods was compared .Results:In the LRFA group ,the tumor complete necrosis rate was 86 .67%,the tumor incomplete necrosis rate was 10.00% and the tumor part necrosis rate was 3.33%.In the traditional group all patients ' lesion was completely excised .There was no significant difference in serum AFP between the two groups before ,2 weeks after and 4 weeks after the treatment (P>0.05).2 weeks and 4 weeks after treatment,the levels of serum IFN-γ,CD3 +,CD4 +,CD4 +/CD8 +in LRFA group were higher than those in the traditional group (P<0.05).The 2-year survival rate of the LRFA group was higher than that of the tra-ditional group (50.00%vs.23.33%,P<0.05).Conclusions:The clinical effect of LRFA is similar to that of traditional surgery in treatment of primary liver cancer ,while LRFA can improve the early level of immunology .