摘要
目的探讨三氧化二砷联合经导管肝动脉化疗栓塞术(transarterial chemoembolization, TACE)治疗原发性肝癌对肿瘤标志物、免疫功能及凋亡分子的影响。方法收集2015年7月至2018年12月于中国人民解放军总医院第六医学中心就诊并接受TACE治疗的中晚期原发性肝癌患者110例进行回顾性分析,根据TACE药物将其分为对照组(奥沙利铂+氟尿嘧啶+吡柔比星碘油乳剂)及三氧化二砷组(奥沙利铂+氟尿嘧啶+三氧化二砷碘油乳剂)。TACE术前及术后1周时,比较两组患者肿瘤标志物水平、T淋巴细胞亚群分布情况、凋亡分子水平的差异。结果术前两组甲胎蛋白(AFP)、岩藻糖苷酶(AFU)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)比值、可溶性Fas(sFas)、可溶性Fas配体(sFasL)比较,差异均无统计学意义(P>0.05)。TACE术后1周两组AFP、AFU、CEA、CA19-9、CD8^(+)T淋巴细胞及sFas、sFasL较治疗前降低,CD3^(+)、CD4^(+)T淋巴细胞、CD4^(+)/CD8^(+)比值较治疗前升高(P<0.05),且三氧化二砷组AFP、AFU、CEA、CA19-9、CD8^(+)T淋巴细胞低于对照组,CD3^(+)、CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)比值高于对照组(P<0.05)。结论三氧化二砷联合TACE治疗原发性肝癌在降低肿瘤恶性程度、优化机体免疫功能方面具有积极作用。
Objective To investigate the effects of Arsenic trioxide combined with transarterial chemoembolization(TACE) on tumor markers, immune function and apoptotic molecules in primary liver cancer. Methods 110 advanced primary liver cancer patients who were admitted to the Sixth Medical Center of PLA General Hospital and received TACE from Jul. 2015 to Dec. 2018 were retrospectively analyzed, and then they were divided into control group(received Oxaliplatin+Fluorouracil+Pirarubicin lipiodol emulsion), Arsenic trioxide group(received Oxaliplatin+Fluorouracil+Arsenic trioxide lipiodol emulsion) according to TACE drugs. Before and 1 week after TACE, the difference of tumor marker levels, T lymphocyte subgroup distribution and apoptotic molecule levels were compared between the two groups. Results There were no significant differences between the two groups of alpha-fetoprotein(AFP), fucosidase(AFU), carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9(CA19-9), CD3^(+), CD4^(+), CD8^(+)T lymphocyte, CD4^(+)/CD8^(+)ratio, sFas and sFasL between two groups before TACE(P>0.05). 1 week after TACE, AFP, AFU, CEA, CA19-9, CD8^(+)T lymphocyte, sFas and sFasL were lower than those before treatment, CD3^(+), CD4^(+)T lymphocyte, CD4^(+)/CD8^(+)ratio were higher than those before treatment(P<0.05), and AFP, AFU, CEA, CA19-9, CD8^(+)T lymphocyte, sFas and sFasL of Arsenic trioxide group were lower than those of control group, CD3^(+), CD4^(+)T lymphocyte, CD4^(+)/CD8^(+)ratio were higher than those of control group(P<0.05).Conclusion Arsenic trioxide combined with TACE plays an active role in reducing the tumor malignancy and optimizing the immune function in the treatment of primary liver cancer.
作者
蒋富强
卢伟
杜鹏
张嘉诚
JIANG Fuqiang;LU Wei;DU Peng;ZHANG Jiacheng(Department of Interventional Medicine,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《胃肠病学和肝病学杂志》
CAS
2021年第12期1354-1357,1362,共5页
Chinese Journal of Gastroenterology and Hepatology
基金
吴阶平基金项目(RCYJZX-009)。
关键词
原发性肝癌
肝动脉化疗栓塞术
三氧化二砷
肿瘤标志物
免疫功能
凋亡分子
Primary liver cancer
Transarterzal chemoembolization
Arsenic trioxide
Tumor marker
Immune func-tion
Apoptotic molecule
