微波消融联合DEB-TACE对中晚期肝癌患者免疫功能及预后的影响研究

肝脏 ›› 2023, Vol. 28 ›› Issue (4): 465-468.

微波消融联合DEB-TACE对中晚期肝癌患者免疫功能及预后的影响研究

李海霞, 王秀香, 郭琳, 柴梅, 李媛媛, 高爱华, 宋兆伟

061001 河北沧州市第三医院放射介入科(李海霞),CT室(王秀香),肝病科(郭琳,柴梅,李媛媛,高爱华) ; 沧州市中心医院放射介入科(宋兆伟)

收稿日期:2022-09-30 出版日期:2023-04-30 发布日期:2023-08-29
基金资助:
中国健康促进基金会影像介入科研基金项目(XM_2020_011_0255_01)

Effect of microwave ablation combined with DEB-TACE on immune function and prognosis of patients with advanced hepatocellular carcinoma

LI Hai-xia¹, WANG Xiu-xiang², GUO Lin³, CHAI Mei³, LI Yuan-yuan³, GAO Ai-hua³, SONG Zhao-wei⁴

1. Department of Radiological Intervention, Cangzhou Third Hospital, Hebei 061001, China;
2. Department of CT, Cangzhou Third Hospital, Hebei 061001, China;
3. Department of Hepatology, Cangzhou Third Hospital, Hebei 061001, China;
4. Department of Radiological Intervention, Cangzhou Central Hospital, Hebei 061011, China

Received:2022-09-30 Online:2023-04-30 Published:2023-08-29

摘要/Abstract

摘要： 目的探讨微波消融(MWA)联合载药栓塞微球经肝动脉化疗栓塞(DEB-TACE)对中晚期肝癌患者预后及免疫功能的影响。方法选取2020年4月—2021年9月沧州市第三医院收治的中晚期肝癌70例,单双色号法分成观察组(DEB-TACE联合MWA,n=35)与对照组(TACE联合MWA,n=35)。对比2组血清指标、临床疗效、免疫功能及并发症。结果治疗4周后,观察组甲胎蛋白(AFP)(65.23±9.18)ng/mL、白蛋白(Alb)(33.26±2.61)g/L、天冬氨酸氨基转移酶(AST)(44.24±4.14)μmol/L、总胆红素(TBil)(24.97±4.25)μmol/L明显低于对照组AFP(123.38±13.46)ng/mL、Alb(36.46±2.93)g/L、AST(49.17±5.23)μmol/L、TBil(31.15±5.13)μmol/L(P<0.05)。治疗8周后,观察组CD4⁺为(43.51±9.29)%、明显高于对照组的(33.72±8.31)%(P<0.05);观察组CD8+(24.29±3.35)%,明显低于对照组的(27.14±4.21)%(P<0.05)。观察组总有效率为(85.71%),明显高于对照组的(57.14%)(P<0.05)。2组并发症发生率相比差异无统计学意义(P>0.05)。结论中晚期肝癌采用MWA联合DEB-TACE治疗疗效显著确切,可降低AFP水平,改善患者的肝功能,且安全可靠。

关键词: 中晚期肝癌, 载药栓塞微球经肝动脉化疗栓塞, 微波消融, 免疫功能, 预后

Abstract: Objective To investigate the effects of microwave ablation (MWA) combined with drug-eluting beads(DEB)-transcatheter arterial chemoembolization (TACE) on the prognosis and immune function of patients with advanced hepatocellular carcinoma(HCC). Methods A total of 70 patients with advanced HCC admitted to the hospital from April 2020 to September 2021 were divided into observation group (DEB-TACE combined with MWA, n=35) and control group (TACE combined with MWA, n=35). The two groups of serum indexes, clinical efficacy, immune function and complications were compared. Results The serum levels of Alpha-fetoprotein (AFP), albumin (Alb) aspartate aminotransferase (AST) and total bilirubin (TBil) in the observation group were significantly lower than the control group after 4 weeks of treatment[ (65.23±9.18) ng/mL vs. (123.38±13.46) ng/mL, (33.26±2.61) g/L vs. (36.46±2.93) g/L, (44.24±4.14)μmol/L vs. (49.17±5.23) μmol/L, (24.97±4.25) μmol/L vs. (31.15±5.13) μmol/L, all P<0.05]. After 8 weeks of treatment, CD4+ in the observation group was, significantly higher than control group[(43.51±9.29)% vs. (33.72±8.31)%, (P<0.05)], contrary to CD8+[(24.29±3.35)% vs. (27.14±4.21)%, P<0.05]. The total effective rate in the observation group was higher than the control group[(85.71%) vs. (57.14%), P<0.05]. Between the two groups, there was no difference in the incidence of complications (P>0.05). Conclusion MWA combined with DEB-TACE has a significant and definite curative effect in advanced HCC. Meanwhile, it could also reduce the serum AFP level and improve liver function in patients, which is safe and reliable.

Key words: Advanced liver cancer, DEB-TACE, Microwave ablation, Immune function

李海霞, 王秀香, 郭琳, 柴梅, 李媛媛, 高爱华, 宋兆伟. 微波消融联合DEB-TACE对中晚期肝癌患者免疫功能及预后的影响研究[J]. 肝脏, 2023, 28(4): 465-468.

LI Hai-xia, WANG Xiu-xiang, GUO Lin, CHAI Mei, LI Yuan-yuan, GAO Ai-hua, SONG Zhao-wei. Effect of microwave ablation combined with DEB-TACE on immune function and prognosis of patients with advanced hepatocellular carcinoma[J]. Chinese Hepatolgy, 2023, 28(4): 465-468.

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