CT引导下射频消融术对肺癌患者近期疗效及远期预后的影响

Effect of CT guided radiofrequency ablation on short-term efficacy and long-term prognosis of lung cancer patients

目的探讨CT引导下射频消融术对肺癌患者近期疗效及远期预后的影响。方法依据治疗方法的不同将120例晚期肺腺癌患者分为观察组和对照组,每组60例,对照组患者给予化疗,观察组患者给予化疗联合CT引导下射频消融术治疗。比较两组患者的临床疗效、CT灌注成像参数[血容量、血流量、表面通透性(PS)和平均通过时间(MTT)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+),计算CD4^(+)/CD8^(+))水平、并发症发生情况和随访1年预后情况。结果观察组患者的疾病控制率高于对照组患者,差异有统计学意义(P﹤0.05)。治疗后,两组患者血容量、血流量、PS均低于本组治疗前,MTT均长于本组治疗前,且观察组患者血容量、血流量、PS均低于对照组,MTT长于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)均低于本组治疗前,但观察组患者CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的并发症总发生率为35.00%(21/60),与对照组患者的28.33%(17/60)比较,差异无统计学意义(P﹥0.05)。观察组患者总生存期(OS)、无进展生存期(PFS)均长于对照组,1年总生存率高于对照组,差异均有统计学意义(P﹤0.05)。结论CT引导下射频消融术治疗晚期肺癌能够有效降低肺癌组织血供,改善患者免疫功能,提高临床疗效和远期预后,安全性较好。

Objective To investigate the effect of CT guided radiofrequency ablation on the short-term efficacy and long-term prognosis of lung cancer patients.Method According to different treatment methods,120 patients with advanced lung adenocarcinoma were divided into observation group and control group,with 60 patients in each group.Patients in the control group were given chemotherapy,and patients in the observation group were given chemotherapy combined with radiofrequency ablation under CT guidance.The clinical efficacy,CT perfusion imaging parameters[blood volume,blood flow,permeability surface(PS)and mean transit time(MTT)],T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),calculated CD4^(+)/CD8^(+)),complications and 1-year follow-up prognosis were compared between the two groups.Result The disease control rate in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,the blood volume,blood flow and PS in the two groups were lower than those before treatment,and MTT was longer than those before treatment,the blood volume,blood flow and PS in the observation group were lower than those in the control group,and MTT was longer than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before treatment,but the levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference for the total incidence of complications between the two groups(P>0.05).The overall survival(OS)and progression-free survival(PFS)in the observation group were longer than those in the control group,and the 1-year overall survival rate was higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion CT guided radiofrequency ablation in the treatment of advanced lung cancer can effectively reduce the blood supply of lung cancer tissue,improve the immune function of patients,improve clinical efficacy and long-term prognosis,with good safety.