肝动脉介入栓塞化疗联合高强度聚焦超声消融术在中晚期肝癌综合治疗中的应用效果和安全性分析

The application effect and safety analysis of TACE combined with HIFU ablation in the comprehensive treatment of middle and advanced liver cancer

目的:探讨肝动脉介入栓塞化疗(TACE)联合高强度聚焦超声(HIFU)消融技术对中晚期肝癌患者的影响,分析TACE联合HIFU消融技术的抗肿瘤价值。方法:选择126例接受姑息性治疗的中晚期肝癌患者,根据治疗方案的不同将其分为TACE组(66例)与联合HIFU消融组(60例)。治疗4周后对比组间实体肿瘤治疗效果和免疫功能指标变化,同时随访记录并比较抗肿瘤治疗不良反应情况及生存情况。结果:治疗后两组免疫功能均有明显提升,而联合HIFU消融组分化簇3(CD3^+)、分化簇4(CD4^+)以及分化簇4/分化簇8(CD4^+/CD8^+)显著高于TACE组,两组相比差异有统计学意义(t=6.303,t=6.049,t=2.148;P<0.05);联合HIFU消融组临床受益率高于TACE组,两组相比差异有统计学意义(Z=2.975,P<0.05);联合HIFU消融组1年生存率和2年生存率高于TACE组,两组相比差异有统计学意义(x^2=3.99,x^2=4.33;P<0.05);两组间皮肤烧伤、肝功能损伤和腹部不适并发症相比,差异无统计学意义(x^2=2.235,x^2=0.847,x^2=0.019;P>0.05)。结论:与单独TACE治疗相比,HIFU消融联合TACE能够提高患者免疫功能和抗肿瘤疗效,且生存时间和生存率明显提高,而并发症风险未见明显增加,表明HIFU消融联合TACE能够协同治疗作用,且安全性较为可靠。

Objective： To explore the effect of transcatheter arterial chemoembolization（TACE） combined with high intensity focused ultrasound（HIFU） ablation on patients with middle and advanced liver cancer and to analyze its antitumor value. Methods： 126 patients with middle and advanced liver cancer who received palliative treatment were selected in the research. According to the different treatment program, they were divided into TACE groups（66 cases） which patients received TACE and TACE combined with HIFU ablation group（60 cases） which patients received the treatment of TACE combined with HIFU ablation. After 4 weeks of treatment, the therapeutic effect of solid tumor and the change of immune function indicator of the two groups were compared. At the same time, the results of followup visit were recorded, and adverse reaction of antineoplaston and survival situation were further compared. Results： After treatment, the immune function both of two groups were enhanced, and the cluster of differentiation（CD）3＋, CD4＋, and CD4＋/CD8＋ of TACE combined with HIFU ablation group was significantly higher than that of TACE group（t=6.303, t=6.049, t=2.148, P〈0.05）. While the clinical benefit rate of TACE combined with HIFU ablation group was significantly higher than that of TACE group（Z=2.975, P〈0.05）, and the survival rate of 1 year and survival rate of 2 years of TACE combined with HIFU ablation group were significantly higher than that of TACE group（x2=3.99, x2=4.33, P〈0.05）, respectively. On the other hand, the differences of complications, included skin burn, liver function damage and abdominal discomfort, between the two groups were no significant（x2=2.235, x2=0.847, x2=0.019, P〉0.05）. Conclusion： The technique of TACE combined with HIFU ablation can enhance immune function and the therapeutic effect of antineoplastic, and its advantages includes obvious effect of antineoplastic and safety of usage. Therefore, its application value should be paid higher attention in oncotherapy of solid tumor as this paper＇s suggestion.