沙利度胺联合肝动脉栓塞化疗治疗原发性肝癌随机对照研究

背景与目的:肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)是治疗中晚期肝癌的重要手段.但是如何巩固TACE的效果,进一步提高中晚期肝癌的长期生存,是亟待研究与解决的重要问题.本研究旨在评价沙利度胺联合TACE治疗原发性肝癌的临床疗效,探索以介入治疗为主的中晚期肝癌的综合治疗模式.方法:以疾病进展时间、生存期为观察终点指标,采用前瞻性随机对照研究,对2004年8月至2006年8月入组的96例原发性肝癌患者随机分为治疗组和对照组,治疗组给予沙利度胺200 mg/d口服1～6个月联合TACE,对照组单纯行TACE.TACE用药选用吉西他滨0.4～1.6 g、奥沙利铂100～200 mg、氟尿嘧啶脱氧核苷0.5～1.0 g,栓塞剂选用碘化油、明胶海绵、无水乙醇.观察沙利度胺的不良反应,同时观察患者的生存期并作预后因素分析.结果:治疗组与对照组患者的中位生存期分别为18个月(95%可信区间12～24个月)、13个月(95%可信区间11～15个月),治疗组半年、1年、2年生存率为85.6%、66.2%、29.9%,对照组半年、1年、2年生存率为85.6%、57.2%、29.1%.治疗组与对照组中位疾病进展时间分别为181天(95%可信区间91～271天)和97天(95%可信区间33～161天),差异有统计学意义(P＜0.05).剔除口服沙利度胺不足1个月的病例后,治疗组与对照组中位生存期分别为28个月(95%可信区间11～45个月)和13个月(95%可信区间8～18个月);治疗组半年、1年、2年生存率为97.0%、75.3%、51.0%,对照组分别为84.8%、54.9%、24.6%.Kaplan-Meier生存曲线和log-rank检验结果表明,两组生存期相比差异有统计学意义(P＜0.05).治疗组5例(11.1%)发生严重皮疹,3例(6.7%)严重嗜睡.Cox回归分析表明,TACE次数是影响肝癌预后的独立因素.结论:口服沙利度胺联合TACE较单纯栓塞化疗能明显延长患者疾病进展时间与生存期,TACE次数与预后相关.     

经肝动脉化疗栓塞联合索拉非尼治疗巨大肝癌的临床疗效及安全性观察

目的:探讨经肝动脉化疗栓塞（TACE）联合索拉非尼治疗巨大肝癌的临床疗效及安全性。方法:回顾性分析2009年6月-2013年6月我院收治的85例巨大肝癌（直径≥10cm）患者的临床资料。其中采用TACE联合索拉非尼治疗的患者共26例作为观察组,单纯采用TACE治疗的患者共37例作为对照组1,单纯采用索拉非尼治疗的患者共22例作为对照组2。Kaplan-Meier法绘制三组患者的生存曲线,采用Log-rank比较三组的中位生存期、生存率、中位肿瘤进展时间,观察并对比三组的不良反应发生率。结果:观察组、对照组1、对照组2中位生存期分别为16.3个月（95%CI:10.1～22.3个月）、10.4个月（95%CI:7.2～13.5个月）、6.2个月（95%CI:4.2～5.6个月）,差异具有统计学意义（P<0.05）;观察组1年、2年、3年生存率明显高于其他两组,差异具有统计学意义（P<0.05）;观察组、对照组1、对照组2的中位肿瘤进展时间分别为6.5个月（95%CI:3.2～10.4个月）、3.2个月（95%CI:1.6～5.5个月）、2.3个月（95%CI:1.2～3.4个月）,差异具有统计学意义（P<0.05）。三组的不良反应发生率比较差异无统计学意义（P>0.05）。结论:TACE联合索拉非尼治疗巨大肝癌可以延缓肿瘤进展,延长生存期,安全性和耐受性良好,具有良好的临床应用前景。     

CIK治疗转移性肾癌的临床疗效评价及预后影响因素分析

  目的  评价细胞因子诱导的杀伤细胞(cytokine-induced killer cells, CIK)免疫治疗在晚期转移性肾癌(metastatic renalcell carcinoma, MRCC)治疗中的作用。  方法  连续收集天津医科大学附属肿瘤医院2002年3月至2010年7月接受CIK细胞治疗的80例MRCC患者为治疗组, 88例接受IL-2联合IFN治疗的MRCC患者为对照组。配对因素包括性别、年龄、KPS评分、中性粒细胞计数、血小板、血红蛋白、乳酸脱氢酶、β2-微球蛋白、血钙、确诊至开始内科治疗的时间、转移部位数量等。观察终点为无进展生存期(progression-free survival, PFS)和总生存期(overall survival, OS)。  结果  CIK治疗组患者1、2、3年无进展生存率分别为47%、28%、17%, 而对照组患者分别为36%、15%、10%(P值分别为0.015、0.009、0.019)。CIK治疗组患者1、2、3年总生存率分别为87%、67%、59%, 而对照组患者分别为55%、37%、18%(P均 < 0.001)。CIK治疗组患者的中位PFS、OS明显优于对照组(12个月vs.9个月, P=0.013:46个月vs.18个月, P < 0.001)。多因素分析显示, KPS评分、转移部位数量、CIK细胞治疗的次数与CIK治疗组患者预后具有明显相关性。最佳CIK治疗次数为7次以上。  结论  CIK细胞免疫治疗可以显著改善MRCC患者预后。高KPS评分、无或仅有一个转移部位的患者预后较好, 且增加CIK免疫治疗次数可以使患者更大程度获益。      

自体CIK细胞治疗联合DP方案一线化疗治疗晚期肺腺癌临床研究

目的:观察自体CIK细胞联合多西他赛+顺铂(DP)方案一线化疗治疗晚期肺腺癌的临床疗效。方法:病理明确诊断的100例ⅢB期和Ⅳ期的肺腺癌患者,按照随机数字表法1:1随机分成实验组(DP联合CIK)和对照组(单纯DP化疗)。对两组T细胞亚群、疾病控制率(IDCR)、中位总生存期(MST)、疾病无进展生存期(PFS)进行比较。结果:实验组的疾病控制率(DCR)为86%(43/50),化疗组的DCR为60%(30/50),P<0.005。实验组T细胞亚群CD3~+,CD3~+CD8~+,CD3~+CD56~+在治疗后较治疗前明显升高(P<0.05);对照组CD3~+,CD3~+CD56~+在治疗后较治疗前明显降低,差异有统计学意义(P<0.05)。两组的MST分别为15.20个月(95%CI,11.82个月~18.58个月)和10.50个月(95%CI,8.08个月~12.92个月),差异有统计学意义(P=0.02);PFS分别为6.30个月(95%CI,4.45个月~8.15个月)和5.6个月(95%cI,4.91个月~6.29个月),差异有统计学意义(P=0.013)。结论:CIK联合DP方案治疗晚期肺腺癌,可以调节患者的免疫功能,延长患者的疾病无进展生存期和总生存期,同时未见明显不良反应。     

肝动脉栓塞化疗联合CIK细胞疗法治疗原发性肝癌

目的:〖HT5"SS〗 评价肝动脉栓塞化疗联合细胞因子诱导的杀伤细胞(CIK)疗法治疗原发性肝癌的临床疗效。〖HT5W〗方法: 〖HT5"SS〗以生存期为观察终点指标,采用同期非随机对照方法,对2003年1月至2005年12月接受肝动脉栓塞化疗联合异体CIK细胞疗法的21例原发性肝癌患者(治疗组)与单纯肝动脉栓塞化疗46例患者(对照组)比较,观察两组的生存期差异。〖HT5W〗结果:〖HT5"SS〗 治疗组与对照组中位生存期分别为22个月(95％CI, 7~37)、10个月(95％CI, 8~12)。两组的半年、1年、2年生存率分别为8571%、5835%、48.62%和69.05%、32.74%、3.97%,治疗组生存期明显长于对照组（P＜0.05)。〖HT5W〗结论: 〖HT5"SS〗肝动脉栓塞化疗联合CIK细胞疗法较单纯肝动脉栓塞化疗有可能提高原发性肝癌患者的远期生存率。     

肝动脉化疗栓塞术联合细胞因子诱导的杀伤细胞(CIK)治疗晚期肝癌的系统评价

目的:系统评价肝动脉化疗栓塞术(TACE)联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌(HCC)患者的疗效及安全性,为临床应用与深入研究提供参考。方法:计算机检索Cochrane Library、PubM ed、万方和中国期刊全文数据库、VIP等数据库。收集所有比较肝动脉化疗栓塞术联合细胞因子诱导的杀伤细胞与单纯肝动脉化疗栓塞术治疗原发性肝癌的随机对照试验(RCT)。采用Cochrane协作网RevM an5.2软件进行Meta分析。结果:纳入9个文献,共784例患者。Meta分析结果显示,TACE联合CIK治疗组与单纯TACE治疗组相比,两组的0.5、1、2年生存率、卡氏评分(Karnofsky)提高率、反应率(RR)、CD3+细胞百分比、CD4+细胞百分比差异均有统计学意义,其RR或SMD(95%CI)分别为[RR=1.31,95%CI(1.18,1.47)]、[RR=1.71,95%CI(1.40,2.08)]、[RR=3.24,95%CI(1.97,5.31)]、[RR=1.76,95%CI(1.26,2.45)]、[RR=1.90,95%CI(1.14,3.14)]、[SMD=0.98,95%CI(0.73,1.23)]、[SMD=0.87,95%CI(0.40,1.34)]。而两个治疗组在CD8+细胞的百分比上差异无统计学意义[SMD=-0.02,95%CI(-0.39,0.34)]。结论:相比单纯TACE术,TACE联合CIK疗法不仅可以显著改善晚期肝癌患者的生存质量、免疫功能及治疗反应率等近期疗效,而且也可以提高患者远期生存率。     

DC-CIK细胞联合化疗治疗老年晚期非小细胞肺癌的疗效观察

目的探讨自体树突状细胞(DC)、细胞因子诱导的杀伤细胞(CIK)联合化疗对老年非小细胞肺癌患者的免疫功能、临床疗效、生活质量和毒副作用的影响。方法回顾性分析120例老年晚期非小细胞肺癌患者的临床资料。所有患者接受4个疗程的诺维苯+顺铂(NP)化疗方案。随机分为2组,每组60例患者。A组患者采用自体过继DC/CIK细胞回输2次,每次30天;B组患者DC/CIK细胞回输2次,同时每30天接受免疫治疗2次以上。评价2组间药物不良反应、疾病进展时间(TTP)和总生存率(OS)。结果 120例患者的中位生存时间为13.80个月。1、2、3年总生存率分别为60.0%,21.7%和15.0%。A组患者1、2、3年总生存率分别为56.7%、13.3%和6.7%;B组患者1、2、3年总生存率分别为63.3%、30.0%和23.3%。2组间总生存率差异存在统计学意义(P=0.037)。相比于A组,B组患者的TTP显著延长,TTP中位数从6.2个月(95%CI,5.35~9.24)提高到7.3个月(95%CI,5.45~6.95;P=0.034),且可耐受化学免疫疗法的不良反应,而A组多见化疗引起的血液系统不良反应。结论 DC-CIK细胞联合化疗治疗老年晚期非小细胞肺癌患者的疗效确切,值得临床推广。     

手术联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌疗效的Meta分析

目的:系统评价手术联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌(HCC)患者的疗效.方法:计算机检索 Cochrane Library、PubMed、万方和中国期刊全文数据库等数据库,收集所有比较手术联合细胞因子诱导的CIK与单纯手术治疗原发性肝癌的临床试验.采用Cochrane协作网RevMan5.3软件进行Meta分析.结果:纳入6篇英文文献,共1 250例患者.Meta分析结果显示,手术联合CIK治疗组1年无病生存率[OR=1.92, 95%CI(1.33, 2.76), P=0.000 5]和1年整体生存率[OR=2.93, 95%CI(1.82,4.73), P<0.000 1]优于单纯手术组,差异均有统计学意义;手术联合CIK治疗组3年无病生存率[OR=1.44, 95%CI(1.07,1.93),P=0.02]和3年整体生存率[OR=1.82, 95%CI(1.40, 2.37), P<0.000 01]优于单纯手术组,差异均有统计学意义;两组间的5年无病生存率[OR=1.36, 95%CI(0.94,1.97),P=0.11]及5年整体生存率[OR=1.42, 95%CI(0.96, 2.11),P=0.08]上的差异无统计学意义.结论:相比单纯手术,手术联合CIK疗法可以提高肝癌患者早、中期的无病生存率及总体生存率,对晚期预后的改善不明显.     

CIK细胞免疫治疗晚期消化系统恶性肿瘤的临床疗效评价

目的:评价CIK细胞免疫治疗晚期消化道肿瘤的临床疗效.方法:选择2010年1月至2014年12月武汉市第五医院肿瘤中心晚期消化系统恶性肿瘤患者.观察组接受CIK细胞免疫治疗,对照组给予姑息减症治疗.比较两组患者总体生存率、无疾病进展生存率,淋巴细胞亚群情况.结果:观察组64例,对照组147例.两组病例年龄、性别、分期、肿瘤部位分布构成无统计学差异.淋巴细胞亚群比较,仅CD3+两组有统计学差异(P=0.042),观察组和对照组中位无疾病进展生存时间分别为(5±0.8)月、(4±0.4)月,总体中位生存时间分别为(25±7)月、(30±3)月,两组比较,均无统计学差异,P值分别为0.066和0.240.结论:晚期消化系统恶性肿瘤患者,CIK细胞免疫治疗对于改善肿瘤负荷小、生物学特性稍好的晚期消化系统恶性肿瘤的无疾病进展生存可能有一定意义,但总体生存无明显获益.     

原发性肝癌合并门静脉癌栓术后双路介入治疗的效果评价

目的 评价可手术切除的原发性肝癌(primary hepatocellular carcinoma,PHC)合并门静脉癌栓(portal vein tumor thrombus,PVTT)患者仅行肝动脉化疗栓塞(transcatheter arterial chemo-embolization,TACE)和经皮肝穿刺门静脉化疗(percutaneous transhepatic portal vein chemotherapy,PVC)联合TACE的治疗效果.方法 选择可手术切除的PHC合并PVTT患者36例,随机分成A、B两组,A组患者术后1个月肝功能基本正常后行TACE;B组患者术后1个月肝功能基本正常后行PVC,术后2个月肝功能基本正常后行TACE,对比两组患者的治疗效果和生存情况.结果 A组患者中位生存期13个月;B组患者中位生存期17个月.A组患者1年、2年、3年生存率分别为50.0%、22.2%、11.1%;B组患者1年、2年、3年生存率分别为77.8%、44.4%、33.3%,两组间生存率比较有显著性差异(P<0.05).结论 合并PVTT的PHC患者手术切除后经双路(PVC+TACE)介入治疗比单纯TACE治疗更能提高治疗效果,延长患者生存时间.     

TACE联合PMCT序贯自身肿瘤疫苗与免疫效应细胞治疗大肝癌临床观察

目的：评价经皮肝动脉化疗栓塞（transcatheter arterial,TACE）联合经皮冷循环微波凝固（percataneous micro—wave coaqulation therapy,PMCT）序贯人自体肝癌细胞溶胞产物荷栽树突状细胞（dendritic cells,DC）和细胞因子诱导杀伤（cytokine—induced killer,CIK）细胞、yST细胞治疗原发性大肝癌的临床疗效。方法：收集2008—01-01—2011—12-31徐州解放军第九七医院80例不能切除的原发性大肝癌患者随机分为研究组（过继性细胞免疫治疗）和对照组（TACE＋PMCT）,每组各40例。对照组患者先行TACE,5～7d复查增强CT和彩超了解肿瘤碘油沉积和血供后再行PMCT;研究组TACE＋PMCT方法同对照组,PMCT后行免疫效应细胞（肝癌细胞溶胞产物荷载DC＋CIK细胞＋y6T细胞）治疗,采用静脉回输＋肝瘤体内注射。随访6～36个月,观察治疗前后肿瘤影像学资料（增强CT、彩超）、肝功能、AFP、免疫功能、生活质量、生存及并发症。结果：研究组和对照纽有效率分别为90％和85％,差畀无统计学意义,x2=0．457,P=0．737。研究组治疗后的CD4、CD4’／CD8’和NK细胞均明显高于治疗前、也明显高于对照组的治疗后,差异有统计学意义,P〈0．05。两组治疗后CD4^＋CD25^＋FOXP＋3／CD4^＋均明显低于治疗前,差异有统计学意义,P〈0．05。研究组和对照组治疗后AFP下降〉80％的分别为77．8％和67．5％,差异无统计学意义,x2=2．125,P=0．145。研究组的生存质量明显高于对照组,差异有统计学意义,P〈O．05。研究组的0．5、1和2年生存率分别为95％、80．0％和45％,对照组分别为90％、67．5％和30％,差异无统计学意义,P〈0．05。研究组和对照组中位生存期分别为21和17个月,差异有统计学意义,x^2=657．704,P=0．001。结论：肝动脉化疗栓塞联合冷循环微波凝固并序贯自身肿瘤疫苗和免疫细胞治疗大肝癌有效、安全,能改善患者的免疫功能、生活质量及中位生存,有可能延长患者的生存期。     

Hepatic Resection after Initial Transarterial Chemoembolization Versus Transarterial Chemoembolization Alone for the Treatment of Hepatocellular Carcinoma: A Meta-analysis of Observational Studies

Background: There is no consensus regarding the selection of treatment options for hepatocellular carcinoma (HCC) after initial transarterial chemoembolization (TACE). This meta-analysis aimed to explore the survival benefit of hepatic resection after initial TACE for the treatment of HCC. Materials and Methods: We searched three major databases to identify all relevant papers comparing the outcomes of hepatic resection after initial TACE versus TACE alone for the treatment of HCC. Hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated to evaluate the survival benefit of hepatic resection after initial TACE over TACE alone. Results: Three of 2037 initially identified papers were included. All of them were cohort studies from Asia. There was a significantly better overall survival (OS) in patients undergoing hepatic resection after initial TACE than in those undergoing TACE alone (HR=0.63, 95%CI=0.52-0.76, P<0.00001). The heterogeneity among studies was not statistically significant (P=0.96; I2=0%). Conclusions: Hepatic resection could improve the OS of HCC patients treated with initial TACE. Further randomized controlled trials should be necessary to identify the target population for the sequential use of hepatic resection after initial TACE and to compare the outcomes between patients undergoing hepatic resection after initial TACE session versus those undergoing TACE alone.     

Cytokine-induced killer cell combination with TACE in the treatment of hepatocellular cancers: a meta-analysis

Objective:The aim of the study was to evaluate the ef icacy and safety of cytokine-induced kil er (CIK) cellcombined with transcatheter arterial chemoembolization (TACE) therapy in the treatment of hep...     

得力生注射液联合肝动脉化疗栓塞治疗原发性肝癌的临床研究

目的评价得力生注射液联合经肝动脉化疗栓塞术(transcatheterarterialchemoembolization,TACE)治疗原发性肝癌(hepatocelluarcarcinoma,HCC)患者的临床效果及不良反应。方法选择无手术指征的HCC患者62例,随机分为试验组(得力生联合TACE)32例和对照组(单纯TACE)30例,选用FAP肝动脉化疗方案,试验组加用得力生注射液50ml/d静滴,15d~20d。治疗2个周期后观测患者的近期疗效、细胞免疫功能、生活质量及不良反应。结果试验组有效率为56.3%(18/32),对照组为43.3%(13/30),两组之间差异无统计学意义,(P>0.05)。试验组较对照组生活质量(KPS评分)明显提高,(P<0.05)。试验组细胞免疫功能提高,其中NK细胞升高明显,差异有统计学意义,(P<0.05)。试验组化疗毒副反应减轻,与对照组比较无统计学意义,(P>0.05)。结论得力生注射液联合TACE治疗能提高HCC患生存质量,增强患者的细胞免疫功能。     

外照射配合肝动脉栓塞治疗不能手术切除的原发性肝癌的临床研究

Objective: This study evaluated the therapeutic effect of external beam radiotherapy(RT)combined with transcatheter arterial chemoembolization(TACE)on the patients with unresectable hepatocellular carcinoma(HCC).Methods: From June 1994 to April 2002, 114 patients with unresectable HCC were nonrandomized prospectively stepped into our study.All patients received TACE as initial therapy, except 54 also received combination therapy with external beam therapy.Survival failure patterns were analyzed and compared between the two groups.Results: Overall survival rates in the patients in the radiotherapy group were 65%, 47%, 38% at 1, 2, 3 years, respectively, improved over the non-radiotherapy group rates of 54%, 36.5%, 18% at 1, 2, 3 years, respectively.There was significant difference between two groups(P＜0.05).The survival rates correlated with tumor size, number of tumors, and portal vein embolus.Conclusion: TACE combined with RT is a more effective treatment than TACE alone in patients with unresectable HCC.     

Investigating Up-to-Seven Criteria and APRI (AST Platelet Ratio) as Prognostic Factors in Intermediate-Stage Hepatocellular Carcinoma Patients Who Received Transarterial Chemoembolization

Background: Transarterial chemoembolization (TACE) is one of the locoregional treatments for intermediate-stage hepatocellular carcinoma (HCC). Multidetector computed tomography (MDCT) is a widely used diagnostic tool for HCC. It can also evaluate tumor size, tumor number, and tumor invasion. This study aimed to determine the median survival time in intermediate-stage HCC patients who underwent TACE and to find out  prognostic factors influencing patients’ survival time after TACE. Methods: A computerized search of medical record database in Maharaj Nakorn ChiangMai Hospital from January 2016 to December 2019 revealed 187 intermediate-stage HCC patients who received TACE as the first-line treatment. Results: The median survival time of patients in this study was 9.9 months (95% CI: 8.3-11.6). The patients with aspartate aminotransferase-to-platelet ratio (APRI) less than 0.5 had a significantly better median survival time as compared with patients with APRI ratio more than 0.5; (13.2 months versus 9.9 months, p-value < 0.05). Univariate and multivariate Cox regression analysis demonstrated that tumor number > 7 and tumor size > 5 centimeters (cm) could be considered as independent parameters predicting poor overall survival time in the sufferers (HR 2.64 95%CI 1.68-4.15 and HR 2.38 95%CI 1.32-4.31, respectively). Conclusion: Based on our findings, patients with intermediate-stage HCC who received TACE had a lower median survival time compared to previous studies. However, we identified APRI less than 0.5, tumor size less than 5 cm, and tumor number less than 7 as prognostic factors improving survival time in intermediate-stage HCC patients.     

COCH predicts survival and adjuvant TACE response in patients with HCC

The aim of the present study was to measure the expression of Cochlin (COCH) and analyze its association with survival, recurrence and the benefits from adjuvant transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) following hepatectomy. Patients with high COCH expression levels had a poorer prognosis in terms of overall and disease-free survival rate compared with those with low COCH expression levels. Further analysis revealed that patients with low COCH expression who received TACE experienced markedly lower early recurrence rates compared with those who did not receive TACE. However, patients with high COCH expression with and without adjuvant TACE after resection experienced no difference in disease recurrence rates. The expression of COCH was found to be associated with hepatitis B virus infection, portal vein tumor thrombosis and Barcelona Clinic Liver Cancer stage in HCC. Therefore, the findings of the present study indicated that clinical detection of COCH expression may help estimate the prognosis of patients with HCC, as well as determine whether to administer TACE after surgery to prevent recurrence.     

Hepatitis B virus reactivation in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization therapy

Aim: The effect of transcatheter arterial chemoembolization (TACE) therapy on hepatitis B virus (HBV) reactivation in hepatocellular carcinoma (HCC) patients with prior resolved hepatitis B is not fully understood. Methods: From January 2006 to December 2010, 43 hepatitis B surface antigen (HBsAg)‐negative/anti‐hepatitis B core antigen (HBc) positive patients with newly diagnosed unresectable HCC were enrolled in the study. All underwent TACE therapy. Results: Four patients (9.3%) developed HBV reactivation with mild/moderate hepatitis. The median number of TACE cycles received was 3.5 (range 3–4 cycles). The median time interval between the occurrence of HBV reactivation and the completion of TACE therapy was 3 months (range 1–5 months) and their median HBV DNA level was 1.58 × 10⁴ IU/mL (range, 1.65 × 10³–6.42 × 10⁴ IU/mL). After the introduction of lamivudine at the occurrence of HBV reactivation, all had resolution of hepatitis. An exploratory analysis indicated that significant predictors of HBV reactivation included increased serum total bilirubin coexisting with cirrhosis and the total number of cycles of TACE received. Conclusion: The administration of TACE therapy may increase the risk of HBV reactivation in HBsAg‐negative/anti‐HBc‐positive patients diagnosed with unresectable HCC. Further studies are warranted to explore the optimal management of HBV reactivation in patients with prior resolved hepatitis B.     

经导管动脉栓塞化疗联合冷循环微波消融治疗原发性肝癌的远期随访研究

目的探讨经导管动脉栓塞化疗(TACE)联合冷循环微波消融治疗原发性肝癌的远期疗效。方法根据治疗方式的不同将73例原发性肝癌患者分为对照组(仅行TACE治疗)39例和联合组(行冷循环微波消融联合TACE治疗)34例,比较两组患者的术后生存、局部复发和远处转移情况。结果截至随访结束,联合组与对照组患者的术后1、2年生存率比较,差异均无统计学意义(P﹥0.05);联合组患者的术后3年生存率高于对照组,中位生存时间长于对照组(P﹤0.05)。两组患者的术后1年局部复发率比较,差异无统计学意义(P﹥0.05);联合组患者的术后第2、3年局部复发率均低于对照组(P﹤0.05)。两组患者的第1、2、3年远处转移率比较,差异均无统计学意义(P﹥0.05)。结论对于原发性肝癌患者,冷循环微波消融联合TACE对于提高生存率、延长生存时间、降低局部复发率均具有一定作用。