RFA联合ＴＡＣＥ和HFH对兔肝VX2肿瘤的作用

目的 探讨肝细胞癌(HCC)伴脾功能亢进患者肝脾联合切除术后免疫功能和肝功能的变化.方法 回顾性分析126例HCC伴脾功能亢进患者的临床资料.根据不同手术方式分2组肝脾联合切除58例(A组),单纯肝癌切除68例(B组).比较两组术后血清总胆红素、转氨酶及免疫功能状况.结果 术后7 d血清总胆红素A,B组分别为(25±6)μmol/L和(3 8±12)μmol/L,差异有显著性(P＜0.05);术后7 d,A组和B组谷丙转氨酶(ALT)和谷草转氨酶(AST)分别为(49.8±35.8)U/L和(71.8±57.4)U/L,(45.6±39.3)U/L和(61.4±41.2)U/L,两组差异均有显著性(P＜0.05).A,B组两个月后CD4和CD4/CD8分别为(41.7±4.2)和(32.6±3.5),(1.9±0.21)和(1.1±0.18),差异均有显著性(P＜0.05).A,B组术后并发症发生率分别为7.24%(10/58)和16.18%(11/68),差异无显著性(P＞0.05),A,B组3和5年无瘤生存率分别为50.0%(14/28)和32.26%(10/31),37.50%(3/8)和20.0%(2/10),差异均有显著性(P＜0.05).结论 肝脾联合切除治疗HCC伴脾功能亢进可促进机体T细胞亚群恢复平衡,改善机体抗肿瘤免疫功能,并可减轻术后肝脏胆红素代谢的负担,促进肝功能恢复.术后并发症发生率并不增加,3年和5年无瘤生存率明显提高.

The effect of radiofrequency ablation combined with transcatheter arterial chemoembolization and high frequency hyperthermia on rabbit liver VX2 carcinoma

Abstract:Objective:To evaluate the effect of radiofrequency ablation (RFA) comblined with high frequency hyperthermia (HFH) and transcatheter arterial chemoembolization (TACE) on rabbit liver VX2 tumor.
Methods :Rabbit liver VX2 tumor models were divied into the following group: Group A, RFA+TACE+HFH; Group B, RFA+HFH; Group C, FA+TACE; Group D, TACE+HFH.The changes of ALT, hot shock protein 70(HSP 70)expression of liver and dendritic cells (DCs) expression of spleen before and after therapy were observed.
Results:(1)ALT: value of ALT was markedly elevated on 1d after therapy in all groups, but was greatest in Group A and also was the slowest to recover at 14 d; the degree of elevation was least in Group B and was the fastest to recover (P<0.05). (2)HSP70 expression: It was markedly elevated in Group A and was still the highest at 14 d; the degree of elevation was least in Group D and was the lowest at 14 d (P<0.05).(3).DCs expression: There was no difference between Groups A and B at 14 d and 7 d (P>0.05); and Groups C and D were markedly lower than the A and B group, and declined more quickly (P<0.05).
Conclusions:RFA+TACE+HFH can effectively activate the expression of Hsp70 and DCs, and enhance antitumorimmunopotency of the organism, but, at the same time, can most markedly damage liver function. Therefore, their combined use should be given an all-round consideration.