经动脉免疫化疗栓塞对肝癌患者免疫功能及血清肿瘤标志物水平的影响

Effect of transcatheter arterial immune chemoembolization on the levels of serum tumor markers and the immune function of patients with hepatocellular carcinoma

目的探讨经动脉免疫化疗栓塞(TAICE)对肝癌患者免疫功能及血清肿瘤标志物水平的影响。方法选择2012年1月至2015年1月在铜川矿务局中心医院住院治疗的肝细胞癌患者82例,其中采用经动脉化疗栓塞(TACE)治疗41例(TACE组),TAICE治疗41例(TAICE组)。分别于治疗前及治疗后28 d检测2组患者血清CD4+、CD8+、CD4+/CD8+、甲胎蛋白(AFP)、癌胚抗原(CEA)及α-L-岩藻糖苷酶(AFU)水平,并进行比较。结果治疗前2组患者血清CD4+、CD8+水平及CD4+/CD8+比较差异均无统计学意义(P>0.05)。TACE组患者治疗后血清CD4+水平及CD4+/CD8+显著高于治疗前(P<0.05),CD8+水平差异无统计学意义(P>0.05)。TAICE组患者治疗后血清CD4+水平及CD4+/CD8+显著高于治疗前(P<0.05),CD8+水平显著低于治疗前(P<0.05)。治疗后TAICE组患者血清CD4+/CD8+显著高于TACE组(P<0.05),但2组患者血清CD4+、CD8+水平比较差异均无统计学意义(P>0.05)。治疗前2组患者血清AFP、CEA及AFU水平比较差异均无统计学意义(P>0.05)。2组患者治疗后血清AFP、CEA及AFU水平均显著低于治疗前(P<0.05)。治疗后TAICE组患者血清AFP和AFU水平显著低于TACE组(P<0.05),但2组患者血清CEA水平比较差异无统计学意义(P>0.05)。结论 TAICE可显著改善肝癌患者的免疫功能,降低血清AFP和AFU水平。

Objective To investigate the effect of transcatheter arterial immune chemoembolization（ TAICE） on the levels of serum tumor markers and the immune function of patients with hepatocellular carcinoma. Methods Among the 82 patients with hepatocellular carcinoma who were selected in the Central Hospital of Tongchuan Mining Bureau from January2012 to January 2015,41 patients were treated with transcatheter arterial chemoembolization（ TACE group）,the other 41 patients were treated with TAICE（ TAICE group）. The levels of serum CD4＋,CD8＋,CD4＋/ CD8＋,alpha-fetoprotein（ AFP）,carcinoembryonic antigen（ CEA） and α-L-fucosidase（ AFU） were compared between the two groups at the time points of before treatment and 28 days after treatment. Results There was no significant difference in the levels of serum CD4＋,CD8＋and CD4＋/ CD8＋between the two groups before treatment（ P〈0. 05）. The levels of serum CD4＋and CD4＋/ CD8＋after treatment were significantly higher than those before treatment（ P〈0. 05）,but there was no significant difference in CD4＋/ CD8＋preand posttreatment in TACE group（ P〈0. 05）. Compared with pretreatment,the levels of serum CD4＋and CD4＋/ CD8＋were significantly higher（ P〈0. 05）,and the CD8＋level was significantly lower after treatment in TAICE group（ P〈0. 05）. The CD4＋/ CD8＋in TAICE group was significantly higher than that in TACE group after treatment（ P〈0. 05）,but there was no significant difference in the levels of serum CD4＋and CD8＋between the two groups after treatment（ P〈0. 05）. There was no significant difference in the levels of serum AFP,CEA and AFU between the two groups before treatment（ P〈0. 05）. The levels of serum AFP,CEA and AFU after treatment were significantly lower than those before treatment in the two groups（ P〈0. 05）. The levels of serum AFP and AFU in TAICE group were significantly lower than those in TACE group after treatment（ P〈0. 05）. But there was no significant difference in serum CEA level between the two groups after treatment（ P〈0. 05）.Conclusion TAICE can significantly improve the immune function of patients,and decrease the levels of serum AFP and AFU in patients with hepatocellular carcinoma.