间充质干细胞MRCS-CD联合TACE治疗中晚期原发性肝癌近远期效果及对患者生活质量影响

Short-term and Long-term Effects of Mesenchymal Stem Cells MRCS-CD Combined with TACE in the Treatment of Middle and Late Stage Primary Liver Cancer and Its Impact on Patients’ Quality of Life

目的:探讨间充质干细胞机械无反应细胞系统(MRCS)-胞嘧啶脱氨酶(CD)联合肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌近远期效果及对患者生活质量的影响。方法:收集甘肃省第二人民医院2017年4月-2020年12月收治的60例中晚期原发性肝癌患者作为研究对象,根据随机数字表法将60例患者分为MRCS-CD组与对照组,各30例。MRCS-CD组给予间充质干细胞MRCS-CD联合TACE治疗,对照组给予TACE治疗,两组治疗观察时间为6个月,观察并分析两组客观缓解率、毒副反应发生情况、生活质量评分、循环肿瘤DNA(ctDNA)及随访生存时间。结果:治疗后MRCS-CD组的客观缓解率为86.7%,高于对照组的60.0%(P<0.05)。两组治疗期间的毒副反应发生情况比较,差异无统计学意义(P>0.05)。治疗后MRCS-CD组的精神健康、情感职能、社会关系功能、总体健康状况、心理职能、生理功能等生活质量指标评分较对照组高(P<0.05)。治疗后两组的ctDNA相对表达水平低于治疗前,且MRCS-CD组低于对照组(P<0.05)。所有患者治疗后随访到2022年2月1日,平均随访时间为(31.92±4.20)个月,MRCS-CD组的无进展生存时间与总生存时间长于对照组(P<0.05)。结论:间充质干细胞MRCS-CD联合TACE治疗中晚期原发性肝癌能提高近期治疗效果,可减少毒副反应,能提高生活质量,降低ctDNA水平,延长患者的长期生存时间。

Objective:To investigate the short-term and long-term effects and influence on quality of life of mesenchymal stem cells mechanoresponsive cell system (MRCS)-cytosine deaminase (CD) combined with transcatheter arterial chemoembolization (TACE) in the treatment of patients with middle and late stage primary liver cancer.Method:A total of 60 patients with middle and late stage primary liver cancer who were admitted to Gansu Second People’s Hospital from April 2017 to December 2020 were collected as the research objects,and divided into the MRCS-CD group and the control group according to the random number table method,with 30 cases in each group.The MRCS-CD group was given mesenchymal stem cell MRCS-CD combined with TACE treatment,the control group was given TACE treatment,and the observation time of the two groups were 6 months.The objective remission rate,occurrence of toxic and side effects,quality of life score,ctDNA and follow-up survival time were observed and analyzed between the two groups.Result:After treatment,the objective remission rate in the MRCS-CD group was 86.7%,higher than 60.0% in the control group (P<0.05).There was no significant difference in the occurrence of toxic and side effects between the two groups (P>0.05).After treatment,the scores of quality of life indicators such as mental health,emotional function,social relationship function,general health status,psychological function,and physiological function in the MRCS-CD group were higher than those in the control group (P<0.05).After treatment,the relative expression levels of circulating tumor DNA (ctDNA) in the two groups were lower than those before treatment,and the MRCS-CD group was lower than that in the control group (P<0.05).All patients were followed up until February 1,2022,with an average follow-up time of (31.92±4.20) months.The progression-free survival time and overall survival time of the MRCS-CD group was longer than that of the control group (P<0.05).Conclusion:Mesenchymal stem cells MRCS-CD combined with TACE in the treatment of middle and late stage primary liver cancer can improve the short-term treatment effect,reduce the occurrence of toxic and side effects,improve the quality of life of patients,reduce ctDNA levels,and prolong the long-term survival time of patients.