手术联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌疗效的Meta分析

Efficacy of surgery combined with cytokine induced killer cells in the treatment of primary liver cancer:A Meta-analysis

目的:系统评价手术联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌(HCC)患者的疗效。方法:计算机检索Cochrane Library、Pub Med、万方和中国期刊全文数据库等数据库,收集所有比较手术联合细胞因子诱导的CIK与单纯手术治疗原发性肝癌的临床试验。采用Cochrane协作网Rev Man5.3软件进行Meta分析。结果:纳入6篇英文文献,共1 250例患者。Meta分析结果显示,手术联合CIK治疗组1年无病生存率[OR=1.92,95%CI(1.33,2.76),P=0.000 5]和1年整体生存率[OR=2.93,95%CI(1.82,4.73),P<0.000 1]优于单纯手术组,差异均有统计学意义;手术联合CIK治疗组3年无病生存率[OR=1.44,95%CI(1.07,1.93),P=0.02]和3年整体生存率[OR=1.82,95%CI(1.40,2.37),P<0.000 01]优于单纯手术组,差异均有统计学意义;两组间的5年无病生存率[OR=1.36,95%CI(0.94,1.97),P=0.11]及5年整体生存率[OR=1.42,95%CI(0.96,2.11),P=0.08]上的差异无统计学意义。结论:相比单纯手术,手术联合CIK疗法可以提高肝癌患者早、中期的无病生存率及总体生存率,对晚期预后的改善不明显。

Objective： To evaluate the effectiveness of surgery combined with cytokine - induced kill cell （ CIK） in the treatment of hepatocellular carcinoma. Methods ： Controlled clinical trial on surgery combination with cytokine - induced killer（CIK） cells were identified by electronic searches in the Cochrane Library, Pub Med, Wanfang, CNKI and other electronic databases. Meta - analysis was conducted by the Cochrane Collaborations Rev Man 5. 3 software. Results：A total of 6 studies involving 1 250 patients were included. The results of Meta - analyses showed that the 1 year disease - free survival rate[ OR = 1.92, 95% CI（ 1.33 , 2. 76 ） , P =0. 000 5 ] and 1 year overall survival rate [OR = 2. 93 , 95% CI（ 1.82,4. 73 ） , P 〈0. 000 1 ] of the surgery combined with CIK treatment group were better than that of the simple surgery group,the difference was statistically significant. The 3 years disease - free survival rate[ OR = 1.44, 95% CI（ 1.07,1.93） = 0. 02 ] and 3 years overall survival rate [ OR = 1 . 82,95% CI（ 1.40,2. 37） , P 〈0 .000 01 ] of the surgery combined with CIK treatment group were better than that of the simple surgery group, the difference was statistically significant. 5 years disease - free survival rate [OR = 1.36, 95% Cl （0.94,1.97）,P =0.11] and 5 years overall survival rate[ OR = 1.42, 9 5 % Cl （0. 96, 2. 11 ） = 0. 08 ] between the twogroups were not statistically significant difference. Conclusion ： Compared with simple surgery, surgery combined with CIK therapy can improve the disease free survival rate and overall survival rate of patients with hepatocellular carcino-ma in early and middle stage, but no significant improvement in the prognosis of advanced stage.