生物化疗对原发性肝癌的疗效及血清IL-2、IL-12水平的影响

Effect of Biochemotherapy on Serum Cytokines in Patients with Primary Liver Cancer

目的 探讨生物化疗对原发性肝癌 (PLC)的疗效及其对患者血清IL -2、IL -12水平的影响。方法 60例PLC患者 ,随机分为 2个组 ,即单纯经肝动脉栓塞化疗 (TACE)组 (以下简称TACE组 ) 3 5例 ,生物化疗 (BIO )组 (以下简称BIO组 ) 2 5例。BIO组于TACE后第 3天开始接受IL -2 (IL -2 10 0万U /天× 10天 ,静脉点滴 )及IFN -γ(5 0万U /天× 10天 ,肌肉注射 )治疗。采用酶联免疫吸附法 (ELISA)检测治疗前后血清IL -2、IL -12水平 ,同时观测肿瘤体积变化情况。结果 BIO组用药后血清IL-2、IL -12水平显著高于TACE组 (P <0 .0 1)。 43例不能手术的患者中无完全缓解 (CR )者 ,BIO组 18例中部分缓解 (PR ) 4例(2 2 .2 % ) ,无变化 (SD) 11例 (61.1% ) ,进展 (PD ) 3例 (16.7% ) ,有效率为 83 .3 % ;TACE组 2 5例中PR 2例 (8.0 % ) ,SD 15例(60 .0 % ) ,PD 8例 (3 2 .0 % ) ,有效率为 68.0 % ;BIO组疗效 (83 .3 % )优于TACE组 (68.0 % ) (P <0 .0 5 )。 2组PR和PD率比较有显著性差异 (P <0 .0 5 ) ,2组SD率比较无显著性差异 (P >0 .0 5 )。结论 生物化疗是治疗PLC的 1种积极有效的方法 ,可作为不能手术PLC患者的可行性治疗方法 ,也可作为PLC术后的 1种良好的辅助治疗手段 ;IL -2和IFN -γ的联合应用是

Objective To study the effect of biochemotherapy in patients with primary liver cancer(PLC) and the possible immunological mechanism.Methods 60 patients were randomly received transcatheter arterial chemoembolization(TACE)(n=35),or both TACE and biochemotherapy(TACE-BIO)(n=25).The biochemotherapy bagan with interleukin(IL)-2 and IFN on the 3rd day after TACE.The serum concentration of IL-2,IL-12 was measured by enzyme-linked immunosorbent assay(ELISA).Results Serum IL-2,IL-12 levels were significantly higher in the patients with TACE-BIO than in the patients with TACE(P< 0.01).There were no complete responses(CR) in 43 inoperable patients,of which 6 patients had a partial response(PR),26 patients had static disease(SD),and only 11 patients had progressive disease(PD).4 of the 6 inoperable patients who had a partial response after treatment(3 by TACE-BIO and 1 by TACE)was able to receive surgical resection.The increase of IL-12 and IL-2 correlated with a better response to treatment.The effect of TACE-BIO is better than that of TACE.Conclusion TACE-BIO is effective in PLC and may improve the prognosis of PLC after operation.Combined usage of IL-2 and IFN-γ is a preferable biochemotherapy.