氩氦刀冷冻消融与微波消融治疗原发性肝细胞癌近期疗效及对免疫功能的影响

Short-term effect of argon-helium cryoablation and microwave ablation for primary hepatocellular carcinoma and impact on immune function

目的对比CT引导下氩氦刀冷冻消融与微波消融治疗原发性肝细胞癌(pHCC)近期疗效及对患者免疫功能的影响。方法回顾性分析52例原发性pHCC患者,其中24例接受CT引导下氩氦刀冷冻消融(冷冻组)、28例接受CT引导下微波消融(微波组),比较2组消融后1个月疗效,分析组间及组内消融前1日与消融后4周外周血CD4^(+)、CD8^(+)T淋巴细胞占比及CD4^(+)/CD8^(+)的差异。结果消融后1个月,冷冻组客观缓解率(87.50%)与微波组(85.71%)差异无统计学意义(P=0.833)。消融前1日,组间外周血CD4^(+)、CD8^(+)T淋巴细胞占比及CD4^(+)/CD8^(+)差异均无统计学意义(P均>0.05);消融后4周,组间外周血CD4^(+)、CD8^(+)T淋巴细胞占比及CD4^(+)/CD8^(+)差异均有统计学意义(P均<0.05),外周血CD4^(+)T淋巴细胞占比及CD4^(+)/CD8^(+)均较消融前1日升高(P均<0.001)、CD8^(+)T淋巴细胞占比较消融前1日降低(P均<0.001)。结论氩氦刀冷冻消融与微波消融治疗pHCC近期疗效确切且相当,前者增强免疫功能的效果更佳。

Objective To compare the short-term effect of argon-helium cryoablation and microwave ablation under the guidance of CT for primary hepatocellular carcinoma(pHCC)and impact on patients'immune function.Methods A total of 52 patients with pHCC were retrospectively analyzed,including 24 cases underwent CT-guided argon-helium cryoablation(cryoablation group)and 28 underwent CT-guided microwave ablation(microwave group).The therapeutic effects were compared between groups 1 month after ablation,the proportion of CD4^(+)T lymphocytes,CD8^(+)T lymphocytes and CD4^(+)/CD8^(+)in peripheral blood were also compared between groups and within group 1 day before and 4 weeks after ablation.Results One month after ablation,there was no significant difference of the objective remission rate between cryoablation group(87.50%)and microwave group(85.71%,P=0.833).There was no significant difference of the percentage of CD4^(+)T lymphocytes,CD8^(+)T lymphocytes nor CD4^(+)/CD8^(+)between groups 1 day before ablation(all P>0.05),while significant differences of the proportion of CD4^(+)T lymphocytes,CD8^(+)T lymphocytes and CD4^(+)/CD8^(+)were found in both groups 4 weeks after ablation(all P<0.05).Four weeks after ablation,the percentage of CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)in peripheral blood of all patients were higher than those 1 day before ablation(all P<0.001),while the percentage of CD8^(+)T lymphocytes were lower than those 1 day before ablation(both P<0.001).Conclusion Both argon-helium cryoablation and microwave ablation had exact and similar short-term efficacy for treating pHCC,and the former had better effect on improving patients'immune function.