摘要
目的探讨经肝动脉化疗栓塞联合射频消融治疗乙肝相关原发性肝癌(hepatitis B virus-related primary hepatocellular carcinoma,HBV-HCC)的疗效及其对α-L-岩藻糖苷酶及免疫功能的影响。方法选取2005年9月至2012年5月间我院诊治的102例HBV-HCC为研究对象,将所有患者按照治疗方式的不同分为肝动脉化疗栓塞术联合射频消融治疗组(联合组)和单独肝动脉化疗栓塞术治疗组(单独组),每组各51例。分别比较2组患者近远期临床疗效、α-L-岩藻糖苷酶和免疫功能指标的改变。结果单独组和联合组的治疗有效率分别为49.01%(25/51)和80.39%(41/51),联合组显著高于单独组(χ2=10.990,P=0.001),但2组患者疾病控制率和不良反应发生率差异并无统计学意义(P>0.05);联合组1年生存率、2年生存率、3年生存率依次为78.43%(40/51)、68.62%(35/51)和54.90%(28/51);联合组患者的平均生存时间和2、3年生存率均明显高于单独组(P<0.05);而且联合组患者的局部复发率与转移率也明显低于单独组(χ2=4.317,P=0.038);治疗后2组患者Ig M、Ig G、CD4+(%)、CD4+/CD8+水平显著升高,补体C3、CD8+(%)和α-L-岩藻糖苷酶明显下降(P<0.05),并且联合组患者上述各项指标的改善幅度均优于单独组(P<0.05);但是2组患者Ig A含量、补体C4和CD3+(%)水平治疗前后却无明显差别(P>0.05)。结论肝动脉化疗栓塞联合射频消融可显著提高HBV-HCC患者的近远期临床疗效,降低α-L-岩藻糖苷酶水平,增强机体免疫功能。
The therapy of hepatocellular carcinoma is still a difficult task in clinical practice. In the present study, we investigated the curative effect of hepatic artery chemoembolization combined with radiofrequency ablation in the treatment of chronic hepatitis B-related primary hepatocellular carcinoma（HBV-HCC） and its effect on the α-L fucosidase and immune function. Total of 102 cases of HBV-HCC from September 2005 to May 2012 in our hospital were selected as the research object, and randomly divided into hepatic arterial chemoembolization combined with radiofrequency ablation group（combined group） and single hepatic arterial chemoembolization group（single group） according to the different treatment, with 51 cases in each group. The short-term and long-term clinical effects, the level of α-L fucosidase and immune function indexes were detected and compared. Data showed that the total efficiency rate of single group and combined group was 49.01%（25/51） and 80.39%（41/51）, which was significant deference（χ2=10.990, P=0.001）, but there was no significant difference on the disease control rate and adverse reaction incidence rate between two groups（P〉0.05）. The 1-year, 2-year and 3-year survival rate of combined group were 78.43%（40/51） and 68.62%（35/51） and 54.90%（28/51）, respectively; the average survival time, 2-, 3- year survival rate of combined group were all significantly higher than those of the single group（P〈0.05）, and the local recurrence rate and metastasis rate of combined group also significantly lower than those of single group（χ2=4.317, P=0.038）. After treatment, the levels of Ig M, Ig G, CD4＋（%） and CD4＋/CD8＋were significantly increased, while the complement C3, CD8＋（%） and α-L fucosidase were decreased remarkably（P〈0.05）, andthe magnitude of improvement on these indicators in the combined group were much better than the single group（P〈0.05）, but no significant difference was observed on the Ig A, complement C4 and CD3�
出处
《免疫学杂志》
CAS
CSCD
北大核心
2015年第11期973-977,982,共6页
Immunological Journal
关键词
原发性肝癌
乙肝病毒
射频消融
肝动脉化疗栓塞
Primary hepatocellular carcinoma
Hepatitis B virus
Radiofrequency ablation
Transcatheter arterial chemoembolization
