TACE和RFA对原发性肝癌的疗效及对细胞免疫、血清相关标志物水平的影响

目的 探讨经肝动脉化疗栓塞(TACE)联合射频消融术(RFA)治疗原发性肝癌患者的疗效及其对患者T淋巴细胞亚群、血清相关标志物水平的影响.方法 选取98例原发性肝癌患者,根据治疗方法的不同将其分为联合组和对照组,每组49例.联合组采用TACE+RFA方案进行治疗,对照组采用TACE方案进行治疗,比较两组患者的治疗效果、T淋巴细胞亚群、血清甲胎蛋白(AFP)、糖类抗原-199(CA-199)、谷氨酰转肽酶(GGT)及血管内皮细胞生长因子(VEGF)水平.结果 治疗后,联合组患者的有效率为71.43％,高于对照组患者的51.02％(P﹤0.05);联合组患者的疾病控制率为95.92％,与对照组患者的91.84％比较,差异无统计学意义(P﹥0.05);治疗前,联合组和对照组患者的CD3+、CD4+、CD8+、CD4+/CD8+水平比较,差异无统计学意义(P﹥0.05);治疗后,联合组患者的CD3+、CD4+、CD4+/CD8+水平明显高于对照组患者(P﹤0.01),CD8+水平明显低于对照组患者(P﹤0.01);治疗前,联合组和对照组患者的AFP、CA-199、GGT、VEGF水平比较,差异无统计学意义(P﹥0.05);治疗后,联合组患者的AFP、CA-199、GGT、VEGF水平明显低于对照组患者(P﹤0.01).结论 原发性肝癌患者采用TACE联合RFA治疗具有更好的临床效果,同时可以改善患者的免疫功能.

Effects of TACE and RFA on the efficacy,cellular immunity and level of serum marker of primary liver cancer

Objective To investigate the efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in patients with primary liver cancer and the effect on T lymphocyte subsets and serum markers. Method A total of 98 patients with primary liver cancer were included in the study, and were stratified as com-bined therapy group or control group with 49 cases in each based on respective treatment administered. combined therapy group was administered with TACE+RFA, and the control group was treated with TACE, the treatment effect, T lympho-cyte subsets and serum alpha fetoprotein (AFP), carbohydrate antigen-199 (CA-199), glutamyl transpeptidase (GGT), and vascular endothelial growth factor (VEGF) were compared between the two groups. Result After treatment, the re-sponse rate was 71.43％ in the combined therapy group, and was significantly higher than that of the control group at 51.02％(P<0.05);the disease control rate was 95.92％in combined therapy group, and was 91.84％in the control group, demonstrating no significant difference (P>0.05);before treatment, there was no significant difference regarding the level of CD3+, CD4+, CD8+, and CD4+/CD8+level between the two groups (P>0.05);while after treatment, the level of CD3+, CD4+and CD4+/CD8+were significantly higher in combined therapy group than that of control group (P<0.05), but CD8+was significantly lower than that in control group (P<0.05);before treatment, consistent level of AFP, CA-199, GGT and VEGF were observed for the two groups (P>0.05);while after treatment, AFP, CA-199, GGT and VEGF were decreased significantly in combined therapy group as compared with control group (P<0.01). Conclusion Patients with primary liv-er cancer have better clinical outcomes when treated with TACE combined with RFA, which may improve the immune function of the patients.