TACE联合射频消融治疗复发性肝癌的临床观察

Clinical Observation of TACE Combined with Radiofrequency Ablation in the Treatment of Recurrent Liver Cancer

目的探讨肝动脉化疗栓塞术(TACE)联合射频消融(RFA)对复发性肝细胞肝癌的治疗效果。方法选取复发性肝细胞肝癌患者70例,将患者随机分为联合组(35例)和对照组(35例),对照组行TACE治疗,联合组采用TACE联合RFA治疗。比较2组患者治疗前后免疫功能[自然杀伤(NK)细胞、T淋巴细胞分化群4+(CD4+)、CD8+]、肝功能[谷草转氨酶(AST)、丙氨酸氨基转移酶(ALT)]以及肿瘤标志物[癌胚抗原(CEA)、糖蛋白抗原199(CA199)、甲胎蛋白(AFP)]水平,比较2组临床疗效、生存期。结果治疗后,2组CD3+、CD4+、NK细胞水平均升高(P<0.05),且联合组高于对照组(P<0.05)。治疗后,2组血清CEA、AFP、CA199水平均降低(P<0.05),且联合组低于对照组(P<0.05);治疗后,2组血清ALT、AST水平均降低(P<0.05),且联合组低于对照组(P<0.05)。联合组有效率高于对照组(P<0.05);联合组生存期及生存率均高于对照组(P<0.05)。结论TACE联合RFA能够明显改善复发性肝细胞肝癌患者的免疫功能及肝功能,降低肿瘤标志物水平,提高疗效及生存率,延长生存期。

Objective To investigate the efficacy of hepatic arterial chemoembolization(TACE)combined with radiofrequency ablation(RFA)in the treatment of recurrent hepatocellular carcinoma.Methods 70 patients with recurrent hepatocellular carcinoma were selected and randomly divided them into combination group(35 cases)and control group(35 cases)accodring to random number table method.The control group was treated with TACE,while the combined group was treated with TACE combined with RFA.Compare the levels of immune function[natural killer(NK)cells,T lymphocyte differentiation group 4+(CD4+),CD8+],liver function[aspartate aminotransferase(AST),alanine aminotransferase(ALT)]and tumor markers[carcinoembryonic antigen(CEA),glycoprotein antigen 199(CA199),and alpha fetoprotein(AFP)]between the two groups before and after treatment.Compare the clinical efficacy and survival period between the two groups.Results After treatment,the cells levels of CD3+,CD4+,and NK in both groups increased(P<0.05),and the combined group was higher than the control group(P<0.05).After treatment,the serum levels of CEA,AFP,and CA199 in both groups decreased(P<0.05),and the combined group was lower than the control group(P<0.05).After treatment,the serum levels of ALT and AST in both groups decreased(P<0.05),and the combined group was lower than the control group(P<0.05).The effective rate of the combined group was higher than that of the control group(P<0.05).The survival period and survival rate in the combined group were higher than those in the control group(P<0.05).Conclusion TACE combined with RFA can significantly improve the immune function and liver function of patients with recurrent hepatocellular carcinoma,reduce the level of tumor markers,mprove the curative effect and survival rate,and prolong the survival period.