灌注栓塞联合微波治疗原发性肝癌效果观察

Efficacy of perfusion embolization combined with microwave in patients with primary liver cancer

目的探讨灌注栓塞联合微波治疗原发性肝癌的效果与机制。方法原发性肝癌患者120例,对照组(60例)给予常规灌注栓塞治疗,治疗组(60例)在对照组治疗的基础上联合微波治疗,疗程4个周期;治疗结束后,观察两组有效性、肝功能、免疫细胞和并发症情况。结果治疗组与对照组的总有效率分别为80.0%与50.0%,治疗期间两组的并发症多为恶心呕吐、疼痛、发热、肝功能不全等,治疗组的并发症发生情况明显低于对照组,两组差异均有统计学意义(P<0.05);治疗结束时,治疗组和对照组NK细胞分别为(17.99±6.44)%和(18.09±6.30)%,CD4+CD25+Treg为(4.44±2.11)%和(7.30±3.09)%,后者在两组间差异有统计学意义(P<0.05);治疗组和对照组AST分别为(41.99±16.44)U/L和(78.09±16.30)U/L,ALT分别为(40.44±12.11)U/L和76.30±13.09),二者在两组间差异均有统计学意义(P<0.05)。结论灌注栓塞联合微波治疗原发性肝癌能有效提高抗瘤效果与恢复肝功能,降低并发症的发生,其作用与降低调节性T细胞活性有关。

Objective To explore the efficacy and mechanism of perfusion embolization combined with mi- crowave in patients with primary liver cancer. Methods 120 cases with primary liver cancer were recruited. Pa- tients in the control group （n=60） were treated with conventional perfusion embolism,and patients in the treat- ment group（n=60） were given perfusion embolism combined with microwave for four cycles. Treatment efficacy,liv- er function,immune cell counts and complication were observed. Results The effective rate of treatment group and control group were 80.0% and 50.0% respectively. The complications which occurred in both groups during the treatment included nausea,vomiting,pain,fever and hypohepatia,however,the complication incidence of the treatment group was significantly lower than that of the control group （P〈0.05）. In terms of immune cells count, NK cell proportion of patients in the treatment group and control group were （17.99±6.44）% and （18.09±6.30）% respectively,and there was difference in CD4＋CD25＋Treg cell proportion between patients of the treatment group （4.44±2.11）% and control group （7.30±3.09）%,P〈0.05. AST and ALT of patients in the treatment group and the control group were also significantly different lAST （41.99±16.44） vs （78.09±16.30） U/L;ALT （80.44±12.11） vs （76.30±13.09） U/L,P〈0.05 for both]. Conclusion Perfusion embolization combined with microwave therapy leads to improved anti-tumor effect,better recovery in liver function,and reduced complications in patients with primary liver cancer,which is associated with lower activity of regulatory T cells.