胸腺肽α1对肝细胞癌患者热消融术后免疫功能及预后的影响

The effects of thymosin alpha 1 on immune function and prognosis for patients with hepatocellular carcinoma after thermal ablation

目的:探讨胸腺肽α1对原发性肝癌患者热消融术后免疫功能及预后的影响。方法:回顾性收集2010年至2012年在河南中医药大学第一附属医院的BCLC-A期原发性肝癌患者热消融术后共80例,按热消融术后是否使用胸腺肽α1分为观察组及对照组(各40例),比较两组患者的免疫功能及远期治疗效果。结果:与对照组相比,观察组消融1年后仍存在较高的CD4^+/CD8^+比值(1.34±0.36 vs 0.64±0.26,P<0.01)。观察组1年生存率、3年生存率及5年生存率分别为97.5%、90.0%及75.0%,对照组1年生存率、3年生存率及5年生存率分别为97.5%、80.0%及57.5%,二者的5年生存率比较差异有统计学意义(P=0.09)。观察组1年无瘤生存率、3年无瘤生存率及5年无瘤生存率分别为97.5%、72.5%及47.5%,对照组1年无瘤生存率、3年无瘤生存率及5年无瘤生存率分别为95.0%、52.5%及27.5%,二者的5年无瘤生存率比较差异有统计学意义(P=0.06)。结论:胸腺肽α1能改善原发性肝癌热消融后患者的CD4^+/CD8^+比值,提高患者的无瘤生存率及总生存率。

Objective： To investigate the effects of thymosin α1 on the immune function and prognosis of hepatocellular carcinoma after thermal ablation. Methods： Clinical data of 80 patients were retrospectively analyzed. They were diagnosed with hepatocellular carcinoma of BCLC-A and treated from 2010 to 2012 at the First Affiliated Hospital of Henan University of Traditional Chinese Medicine. 40 of them were treated with microwave ablation or radiofrequency ablation with thymosin α1（ observation group）,and the other 40 were just treated with microwave ablation or radiofrequency ablation（ control group）. Subset of T cells and long-term efficacies were compared between them.Results： The ratios of peripheral blood CD4＋/CD8＋after 1 year in observation group were significantly higher than control group（ P＜0. 01）. The 1-,3-,5-year overall survival rates were 97. 5%,90. 0% and 75. 0% for the patients in observation group,and in control group they were 97. 5%,80. 0% and 57. 5%. The 1-,3-,5-year recurrence-free survival rates were 97. 5%,72. 5% and 47. 5% for the patients in observation group,and in control group they were 95. 0%,52. 5% and 27. 5%. There were significant differences in 5-year overall survival rate and recurrence free survival rate between the two groups（ P = 0. 09,P = 0. 06）. Conclusion： Postoperative thymosin α1 therapy can improve postoperative immune function of hepatocellular carcinoma,thus significantly prolong recurrence-free survival rate and overall survival rate.