氩氦刀联合肝动脉介入治疗原发性肝癌的免疫效应研究

目的通过比较单纯氩氦刀治疗、单纯肝动脉化疗栓塞治疗（TACE）和氩氦刀联合TACE治疗原发性肝癌前、后的甲胎蛋白（AFP）及T淋巴细胞亚群的变化，探讨氩氦刀联合TACE治疗原发性肝癌的临床价值。方法①将99例原发性肝癌患者随机分为3组，氩氦刀治疗组（A组）、TACE组（B组）和联合组（C组），3组患者性别、年龄、病理比较差异无统计学意义，有可比性。②通过治疗前、后AFP及外周血T淋巴细胞亚群测定评价。结果3组治疗后与治疗前AFP比较差异均有统计学意义（P〈0．05）；C组与A、B组比较差异有统计学意义（P〈0．05）。3组治疗后T淋巴细胞哑群（Th、Ts及Th／Ts）与治疗前比较差异均有统计学意义（P〈0．01）；C组与A、B组比较差异有统计学意义（P〈0．01）。结论从AFP及T淋巴细胞弧群指标分析，氩氦刀联合TACE治疗组AFP下降和T淋巴细胞亚群变化好于其他单纯治疗组。

Argon-helium cryoablation combined with transcatheter arterial chemoembolization for the treatment of primary hepatocellular carcinoma

Objective To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in treating primary hepatocellular carcinoma by comparing the changes of AFP level and T cell immunity after the therapy with that obtained after the treatment of argon-helium cryoablation alone and with that obtained after the treatment of TACE alone. Methods (1) Ninety-nine patients with primary hepatocellular carcinoma were randomly divided into three groups: group A (n=30), treated with argon-helium cryoablation; group B (n=34), treated with TACE; and group C (n=35), treated with argon-helium cryoablation together with TACE. The patients' gender, age and pathology of three groups were comparable with each other. (2) The peripheral blood T cell immunity and AFP level both before and after the treatment were determined and the results were statistically compared. Results After the treatment the AFP level in all 3 groups was significantly reduced when compared to that determined before the treatment (P < 0.05). And the difference in the decrease of AFP level between group C and A, also between group C and B, was statistically significant (P < 0.05). After the treatment the T cell immunity, including Th, TS and Th / TS, in all 3 groups was significantly different from that determined before the treatment (P < 0.01), and significant difference also existed between group C and A and between group C and B (P < 0.01). Conclusion The statistic analysis of AFP and T cell immunity, which are regarded as the index of therapeutic efficacy, indicates that argon-helium cryoablation combined with TACE is superior to simple argon-helium cryoablation and also to simple TACE in the treatment of primary hepatocellular carcinoma.