肝动脉化疗栓塞联合射频消融治疗原发性肝癌效果观察

Results observation of primary liver cancer treatment by transcatheter arterial chemoembolization combined radio frequency ablation

目的观察肝动脉化疗栓塞联合射频消融治疗原发性肝癌的效果。方法选取2014年11月—2016年11月收治的原发性肝癌患者86例,随机分为观察组和对照组各43例。对照组采用肝动脉化疗栓塞治疗,观察组采用肝动脉化疗栓塞联合射频消融治疗。治疗结束2个月,评价两组疗效;用流式细胞仪检测CD_3^+细胞、CD_4/CD_8^+、自然杀伤细胞(natural killer cell,NK)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α);用酶联免疫吸附法测定甲胎蛋白(α-Fetoprotein,AFP)、糖类抗原(carbohydrate antigen199,CA199)、谷氨酰转肽酶(gamma-glutamyl transpeptidase,GGT)。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组有效率90.70%,对照组有效率为62.79%,比较差异有统计学意义(P<0.05)。治疗后,观察组CD_3^+、CD_4/CD_8^+、NK、TNF-α[(67.42±8.73)%、2.16±0.41、(9.27±1.32)%、(1.51±0.22)ng/L]均明显高于对照组[(56.35±7.64)%、1.22±0.21、(6.36±0.82)%、(0.92±0.15)ng/L](均P<0.05)。两组治疗后血清AFP、CA199、GGT水平均低于治疗前(均P<0.05),治疗后观察组AFP、CA199、GGT水平[(76.53±11.67)ng/L、(36.28±5.63)、(88.36±9.47)U/L]均低于对照组(均P<0.05)。结论肝动脉化疗栓塞联合射频消融治疗原发性肝癌近期疗效满意,改善了其免疫功能、减少了远期复发。

Objective To study the clinical effect of primary liver cancer treatment by transcatheter arterial chemoembolization combined radio frequency ablation.Methods Selection from November 2014 to November 2016 treated 86 cases of primary liver cancer patients, randomly divided into observation group and control group （n=43）. The control group was treated with hepatic arterial chemoembolization, while the observation group was treated with hepatic arterial chemoembolization and radiofrequency ablation. Compare two groups of curative effect,Using flow cytometry instrument to detect CD3^± cells factor, CD4^±/CD8^±,Natural Killer ceils （Natural Killer ceil, NK）.Tumor necrosis factor alpha （Tumor necrosis factor alpha, TNF alpha）; Enzyme linked immunosorbent method for determination of AFP （alpha Fetoprotein, AFP）, Carbohydrate antigen （Carbohydrate Antigen199,CA199）, GGTP （Gamma glutamyl Transpeptidase） （Gamma-glutamyl Transpeptidase, GGT）. Measurement data uses t test,and count data uses x^2 test, P〈0.05 is considered statistically significant. Results The observation group effectiveness 90.70%, control group effective rate was 90.70%, compare the difference was statistically significant （P〈0.05）. After treatment, the observation group of CD3^±, CD4^±/CD8^± and NK, TNF alpha [（67.42± 8.73）%, 2.16±0.41, （9.27± 1.32）%, （1.51±0.22） ng/L] were significantly higher than the control group[ （56.35±7.64）%, 1.22 ± 0.21, （6.36 ± 0.82）%, （0.92 ± 0.15）ng/L）] （all P〈0.05）. Two groups after treatment, serum AFP, CA199 and GGT levels are lower than before treatment （all P〈O.05）, AFP, CA199 and GGT levels after treatment group[ （76.53 ± 11.67） ng/ml, （36.28 ± 5.63）, （88.36±9.47） U/L ]were lower than the control group （all P〈0.05）. Conclusion Transcatheter arterial chemoembolization combined radio frequency ablation treatment can improve the immunologic function,which is very valuable clinically.