TACE联合RFA或PEI对原发性肝癌患者免疫功能影响的分析-外科学专业论文.docxVIP

TACE联合RFA或PEI对原发性肝癌患者免疫功能影响的研 究 中 文 摘 要 目的：TACE 联合射频消融（RFA）或无水酒精注射(PEI)对不能手术 切除或不愿手术切除原发性肝癌（PLC）免疫功能影响的研究。 方法：将不能手术切除或不愿手术切除的肝癌患者 70 例，随机分为 TACE+RFA 组 35 例，TACE+PEI 组 35 例。通过流式细胞仪及酶联免疫吸附 法对比肝癌患者治疗前和治疗后一个月外周血 T 细胞亚群、NK 细胞的活 性与 TNF-α的水平，以了解肿瘤患者的免疫功能状况。 结果：两组治疗后一个月与治疗前相比 CD4+T、NK 细胞及 CD4+/CD8+ 的比值显著升高（P＜0.05），CD8+T 及 TNF-α的水平明显下降（P＜0.05）， 各组治疗后 CD3+T 与治疗前相比，差异无统计学意义（P＞0.05）。TACE+RFA 组与 TACE+PEI 组治疗后 CD4+T 比较 P=0.023＜0.05,有统计学差异； TACE+RFA 组与 TACE+PEI 组治疗后 CD4+/CD8+比较 P=0.039＜0.05, 有统 计学差异；TACE+RFA 组与 TACE+PEI 组治疗后 NK 细胞比较 P=0.021＜0.05， 有统计学差异；TACE+RFA 组与 TACE+PEI 组治疗后 TNF-α比较 P=0.014 ＜0.05，有统计学差异。 结论：（1）两种肝癌介入治疗方法都可明显改善肝癌患者的免疫功 能。（2）TACE+RFA 组对肝癌患者的免疫功能的改善优于 TACE+PEI 组。（3） TACE+RFA 联合序贯治疗相互补充、相互协同、安全有效，可明显提高肝 癌患者的免疫功能，是目前临床较理想的治疗方法。 关键词：原发性肝癌，细胞免疫，肝动脉栓塞化疗，射频消融术， 无水酒精注射 Study on the effect of immune function in Patients with Primary hePatocellular carcinoma by TACE combined with RFA or PEI ABSTRACT Objective：TACE combined with radiofrequency ablation (RFA) or Percutaneous ethanol injection (PEI) on not oPeration excision of Primary liver cancer (mainly refers to the hepatocellular carcinoma, HCC) on the immune function of. Method：Will not operation resection or unwilling to operation resection and 70 cases of HCC patients, 35 patients were randomly divided into TACE+RFA, TACE+PEI grouP of 35 cases.By FCM and ELISA method to contrast the activity and liver cancer patients before treatment and after one month of peripheral blood T cell subsets, NK cells of TNF- α levels, in order to understand the status of immune function of patients with tumor Results ： The two group one month after treatment compared with before treatment, the ratio of CD4+T NK cells and CD4+/CD8+ significantly increased (P 0.05), CD8+T and TNF- α level decreased significantly (P 0.05), group CD3+T after treatment compared with before treatment, no significant difference (P 0.05). TACE+RFA group and TACE+PEI group after treatment compared to CD4+T P=0.023 0.05, there was significant difference