肝癌根治性切除术后联合DC-CIK治疗的临床研究

Clinical Investigation of Radical Liver Resection Combined with Postoperative DC-CIK Treatment

目的探讨肝癌根治性切除术联合DC-CIK治疗对原发性肝癌患者的疗效。方法自2011年6月至2014年6月对收治的原发性肝癌患者84例进行前瞻性研究,随机分为DC-CIK组和对照组,各36例。两组患者均给予肝癌切除术和肝动脉介入治疗,DC-CIK组在此基础上给予DC-CIK治疗。采用SPSS22.0进行统计分析,共随访3年,两组患者生活质量(QOL)、细胞因子和AFP等计量资料差异采用独立样本t检验分析;两组患者1~3年生存率(OS)、复发率和毒性反应等计数资料采用卡方检验分析;两组患者无疾病进展时间采用生存函数分析。P<0.05表示差异有统计学意义。结果两组患者术后1~3年OS比较差异无统计学意义(P>0.05)。与对照组比较,DC-CIK组患者术后3年时复发率低于对照组(69.1%比47.6%,P=0.046);无疾病进展时间显著延长[(48.9±2.9)比(38.9±3.4)月,P=0.034]。两组患者术前AFP水平无统计学差异(P>0.05),术后12周时DC-CIK组患者AFP水平显著低于对照组。与对照组比较,DC-CIK组术后12周时CD4^+T细胞、CD4^+/CD8^+、CD3^+CD56^+NKT细胞显著增高(P<0.05)。两组患者治疗前后QOL评分、不良反应差异均无统计学意义(P>0.05)。结论肝癌根治术切除联合DC-CIK治疗有助于提高免疫系统对肿瘤细胞的杀伤作用,改善生活质量、延长无疾病进展时间、降低术后复发率。

Objective To explore the clinical effect of radical liver resection combined with postoperative DC-CIK treatment for patients with primary hepatocarcinoma. Methods From June 2011 to June 2014, 84 patients with primary liver cancer treated in our hospital were studied prospectively. The patients were randomly divided into DC-CIK group （ n =36） and control group （ n =36）. Patients in both two groups underwent hepatectomy and hepatic artery interventional therapy and DC-CIK treatment was performed in DC-CIK group. Statistical analysis were performed by using SPSS22.0 software. 3-years follow-up were completed .The difference of quality of life （QOL）, cytokine and AFP between two groups was analyzed by using independent sample t-test. The 1-3 year survival rate, recurrence rate and toxicity were analyzed by using chi-square test. Time of disease free progression were evaluated by using survival analysis . A P value〈0.05 was considered as significant difference. Results There was no significant difference of OS between two groups from 1 to 3 years after operation （ P 〉0.05）. The recurrence rate in DC-CIK group was lower than that in control group at 3 years after operation （69.1% vs. 47.6%, P =0.046） , with prolonged time of disease free progression [（48.9±2.9） vs. （38.9±3.4） M, P = 0.034] . There was no significant difference in preoperative AFP between the two groups （ P 〉0.05）. The level of AFP in DC-CIK group was significantly lower than that in control group 12 weeks after operation. Compared with the control group, the CD4/CD8^＋ CD3 CD56 NKT cells of CD4 T cells increased significantly 12 weeks after operation in DC-CIK group （ P 〈0.05）. There was no significant difference of QOL score before and after treatment between two groups （ P 〉0.05）. Conclusion Radical liver resection combined with postoperative DC-CIK treatment improves the killing effect of the immune system against cancer cells, with better quality of life, prolonged progression-free time and reduced the postoperative recurrence rate.