高强度聚焦超声联合静脉化疗治疗结肠癌肝转移的短期疗效观察

The short-term effect of treatment of colon cancer liver metastasis by high intensity focused ultrasound combined with intravenous chemotherapy

目的探讨高强度聚焦超声(HIFU)联合静脉化疗治疗结肠癌肝转移的短期治疗效果。方法选取结肠癌伴肝转移患者62例,随机分为静脉化疗组29例和HIFU联合静脉化疗组(联合治疗组)33例,测量两组治疗前后病灶大小评价其疗效,比较两组治疗前后T细胞亚群及NK细胞表达水平并对比分析对HIFU机体免疫功能的影响。结果化疗第4、6周期后联合治疗组病灶总直径分别为(13.012±4.004)cm、(12.319±2.298)cm,较静脉化疗组[(19.624±4.697)cm、(21.756±5.237)cm]小,差异均有统计学意义(均P<0.05)。联合治疗组总体有效23例,静脉化疗组有效9例,两组比较差异有统计学意义(P<0.05)。联合治疗组HIFU治疗后NK细胞、CD3+及CD4+百分率均较治疗前升高(均P<0.05),CD8+细胞百分率较治疗前下降,差异有统计学意义(P<0.05)。结论 HIFU联合静脉化疗治疗结肠癌肝转移效果优于单纯静脉化疗,且HIFU治疗可改善患者免疫功能。

Objective To evaluate the short-term therapeutic effects of colon cancer liver metastasis by high intensity focused ultrasound combined with intravenous chemotherapy . Methods Colon cancer with liver metastasis of 62 cases were randomly divided into vein chemotherapy group（n =29） and HIFU combined with intravenous chemotherapy group（HIFU combined group,n =33）. The diameter of tumor before and after treatment was measured in the two groups to evaluate the therapeutic effect. The expression level of T cell subsets and NK cells were detected in the two groups before and after treatment to evaluate effects on the body’s immune function.Results After 4 and 6 period of chemotherapy,the diameters of the tumors in HIFU combined group were（13.012±4.004） cm and（12.319±2.298）cm,respectively,the values were smaller than those of intravenous chemotherapy group[（19.624±4.697）cm and（21.756±5.237）cm],there was significant difference（all P〈0.05） . The total effective cases in HIFU combined group and chemotherapy group were 23 and 9,there was significant difference （P〈0.05）.NK cells,the percentage of CD3 ＋,CD4 ＋ were increased after HIFU combined treatment,there was significant difference （all P〈0.05）,the percentage of CD8 ＋ cells decreased after the treatment,there was significant difference（P〈0.05）.Conclusion HIFU combined with intravenous chemotherapy is superior to the single venous chemotherapy for the treatment of colon cancer liver metastasis,meanwhile,HIFU treatment can activate the body’s immune system and improve patients’ immune function.