过继免疫治疗在肝细胞性肝癌中的疗效荟萃评价

Effect of adoptive immunotherapy in treatment of hepatocellular carcinoma

[目的]:对肝细胞性肝癌(HCC)术后治疗中过继免疫治疗(AIT)的有效性、安全性进行系统评价。[方法]对中英文数据库进行电子检索,纳入HCC、AIT的随机对照试验(RCT),检索时间为2000~2015年。由2名研究者独立筛选文献,交叉核对,并基于RevMan5.0软件行荟萃分析。[结果]纳入6篇文献,分析结果显示,AIT治疗可有效控制HCC术后1年、3年复发率[95%CI:(0.33~0.64),P<0.01]、[95%CI:(0.62~0.88),P<0.01];对1年死亡率和3年死亡率无较大影响[95%CI:(0.24~1.04),P>0.05]、[95%CI:(0.48~1.06),P>0.05];不良反应主要有短暂性发热、持续性低热、头晕、恶心、头痛、腹水等,未见肝功能衰竭、感染、死亡等。[结论]HCC术后AIT治疗可有效降低复发率,且不良反应较轻,但对生存率并无显著改善。但因纳入研究的方法治疗有待进一步提升,且样本量较小,故还需要高质量、大量本、多中心的试验作进一步证实。

[Objective]To evaluate the efficacy and safety of adoptive immunotherapy（AIT）in postopera- tive hepatocellular earcinoma（HCC）. [Methods] The Chinese and English databases were electronieally searched and included in HCC,AIT randomized controlled trials（RCTs）,and were retrieved from 2000 to 2015. Screening by two researchers,cross-checking, and based on RevMan5.0 software line recta-analysis. I-Results-]Six articles were included. The analysis results showed that AIT treatment could effectively con- trol the recurrence rate of postoperative HCC after 1 years,3 years and the recurrence rates were：~95%Cl （0. 33,0.64）,P^0. 011,[-95~CI（0.62-0.88）,P〈0.01];the 1 year mortality and 3 year mortality rate had no significant effect on[-95~CI（0.24~1.04）,P）0.05~E95%CI. （0.48-1.06）,P〉0.05];The main adverse effects were transient fever,persistent fever, dizziness, nausea, headache and ascites, no liver failure,infection and death. [Condusion]AIT treatment after postoperative HCC can effectively reduce the recurrence rate, and mild adverse reaction, while there is no significant improvement in survival rate. However, due to the inclusion of research methods to be further improved, and the sample size is small,it also needs high quality,a large number,multi-center test for further confirmation.