TACE联合HIFU治疗老年原发性肝癌疗效及对患者免疫功能的影响

Effect of TACE Combined with HIFU on Elderly Patients with Primary Liver Cancer and its Effect on Immune Function

目的:分析探讨肝动脉灌注化疗栓塞(TACE)联合高强度聚焦超声(HIFU)对老年原发性肝癌患者的临床疗效以及对患者免疫功能的影响。方法:选取2012年2月至2014年2月收治的84例老年原发性肝癌患者进行研究,按照随机字母表法进行分组,随机分为对照组和观察组,各42例。对照组患者采用单一TACE治疗,观察组患者采用TACE联合HIFU治疗,对比两组患者治疗后肿瘤体积变化、免疫功能变化,同时比较两组患者中位生存时间以及治疗3年后的生存率。结果:经不同方法治疗后,观察组患者肿瘤体积缩小情况和临床治疗有效率均显著优于对照组(P<0.05),且观察组患者中位生存时间以及治疗1年、2年、3年后的生存率均显著高于对照组(P<0.05)。观察组患者治疗后3个月免疫球蛋白Ig A、IgM、IgG水平分别为[(3.65±0.20)g/L]、[(2.29±0.18)g/L]、[(10.68±0.84)g/L],均分别显著高于对照组的[(3.23±0.24)g/L]、[(1.81±0.15)g/L]、[(8.76±0.67)g/L],两组相比差异具有统计学意义(t=8.71,13.28,11.58;P<0.05);治疗后三个月后观察组患者补体C3、C4水平分别为[(1.49±0.06)g/L]、[(0.34±0.03)g/L],对照组为[(1.31±0.08)g/L]、[(0.22±0.05)g/L],两组相比差异显著(t=11.67,13.34;P<0.05)。结论:老年原发性肝癌患者采用TACE联合HIFU治疗后可以有效的缩小病灶体积,改善患者的免疫动能,提高患者的生存率,延长生存时间,效果显著,值得临床推广。

Objective: To investigate the clinical efficacy of TACE( hepatic arterial chemoembolization)combined with HIFU( high intensity focused ultrasound) in elderly patients with primary liver cancer and its effect on immune function. Methods: 84 patients with primary hepatocellular carcinoma were randomly divided into control group and observation group( n = 42). The patients were randomly divided into control group and observation group. The patients in the control group were treated with TACE alone. The patients in the observation group were treated with TACE combined with HIFU. The changes of tumor volume and immune function were compared between the two groups. The median survival time and the survival rate after 3 years were compared. Results: After treatment with different methods,the tumor volume reduction and clinical treatment efficiency in the observation group were significantly better than those in the control group( P < 0.05). The median survival time and the survival rate of 1,2 and 3 years after treatment in the observation group were significantly higher than those in the control group( P < 0.05). The levels of immune globulin Ig A,Ig M,Ig G of patients in the observation group after treatment of 3 months were [( 3.65 + 0.20) g/L],[( 2.29 + 0.18) g/L],[( 10.68 + 0.84) g/L],were significantly higher than those in the control group [( 3.23 + 0.24) g/L],[( 1.81 + 0.15 g/L]),[( 8.76 + 0.67) g/L]; the difference between the two groups was statistically significant( t = 8.71,13.28,11.58; P < 0.05); At three months after the treatment,the observation group patients complement C3 and C4 levels were [( 1.49 + 0.06) g/L],[( 0.34 + 0.03) g/L],the control group [( 1.31+ 0.08) g/L],[( 0.22 + 0.05) g/L],significant difference between the two groups( t = 11.67,13.34; P <0.05). Conclusion: TACE combined with HIFU in elderly patients with primary liver cancer can effectively reduce the volume of the lesion,improve the immune kinetic energy of patients,improve the survival rate of patients,prolong the survival time,the effect is remarkable,worthy of clinical promotion.