TACE联合HIFU消融治疗肝癌对免疫功能影响的临床研究

发布时间：2018-04-17 15:45

本文选题：肝癌 + 经导管动脉化疗栓塞　；参考：《昆明医科大学》2014年硕士论文

【摘要】：目的：研究TACE联合HIFU消融治疗肝癌疗效和对患者机体免疫功能的影响,为TACE联合HIFU治疗肝癌提供一定的理论依据。探讨TACE联合FIFU治疗肝癌对免疫功能的影响及其临床意义,为临床上TACE联合HIFU治疗肝癌的应用价值提供科学依据。方法：收集本院肝癌患者46例,分成单纯TACE组(对照组)及TACE联合HIFU治疗组(实验组),每组患者各23例。观察两组患者疗效及术前及术后1、3、6、12个月免疫指标(CD3+T细胞、CD4+T细胞、CD8+T细胞、NK细胞、CD4+T细胞/CD8+T细胞比值)及其临床症状的变化情况。结果：对照组术后1月与术前比较CD3+、CD4+、及NK比例及CD4+/CD8+比值升高,CD8+T比例降低；术后3月时与术前比较CD3+、CD4+、及NK比例及CD4+/CD8+比值稍升高,CD8+T比例稍降低；术后6月术前比较CD3+、CD4+、及NK比例及CD4+/CD8+比值略有升高,CD8+比例略有降低；术后12月与术前比较CD3+、CD4+、及NK比例及CD4+/CD8+比值略有降低,CD8+比例略有升高。实验组术后1月与术前对比CD3+、CD4、及NK比例及CD4+／CD8+比值明显升高,CD8+比例明显降低；术后3月与术前比较CD3+、CD4、及NK比例及CD4+/CD8+比值明显升高,CD8+比例明显降低；术后6月与术前比较CD3+、CD4+、及NK比例及CD4+/CD8+比值稍升高,CD8+比例稍降低；术后12月与术前比较CD3+、CD4+、及NK比例及CD4+/CD8+比值略有升高,CD8+比例略有降低。两组数据比较,实验组术后1月、3月与对照组比较增高,有统计意义,术后6月、12月时稍高于对照组,差异没有统计学意义。术后患者临床症状变化如下：全身乏力明显改善的联合治疗组占87.5%(14/16),而对照组46.7%(7/15)；消瘦明显改善的治疗组占75%(9／12),而对照组46.15%(6/13)；纳差明显改善的占84.61%(13/15),而对照组41.67%(5/12)；肝区疼痛明显缓解的治疗组占75%(11/13),而对照组42.85%(6/14)。实验组与对照组术后3个月、6个月、12个月的生存率分别为100.00%、91.31%、78.26%与100.00%、69.60%、56.52%,差异有统计学意义(P0.05)。结论： 1、单纯TACE治疗后患者免疫功能的改变为治疗后1个月明显增强,3、6、12个月后免疫功能较治疗前改变不明显。 2、TACE联合HIFU消融治疗后对比单纯TACE治疗后1、3个月患者免疫功能明显增强,治疗后6、12个月免疫功能与单纯TACE治疗组相同。 3、TACE联合HIFU消融治疗肝癌患者改善患者临床症状及提高生存率效果优于单纯TACE治疗。
[Abstract]:Objective: to study the effect of TACE combined with HIFU ablation on liver cancer and its effect on immune function of patients, and to provide a theoretical basis for TACE combined with HIFU in the treatment of HCC.To explore the effect of TACE combined with FIFU on immune function and its clinical significance, to provide scientific basis for the clinical application of TACE combined with HIFU in the treatment of hepatocellular carcinoma.Methods: 46 patients with liver cancer in our hospital were divided into TACE group (control group) and TACE combined with HIFU group (experimental group, 23 cases in each group).To observe the curative effect of the two groups and the changes of CD 3 T cell / CD 8 T cell / CD 8 T cell / T cell / CD 4 / CD 8 T cell ratio and their clinical symptoms before and after operation.Results: in the control group, CD3 CD4, NK ratio and CD4 / CD8 ratio increased and CD8 T ratio decreased at 1 month after operation, and decreased slightly at 3 months after operation compared with preoperative CD3 CD4, NK ratio and CD4 / CD8 ratio.The ratio of CD3 / CD _ 4, NK / CD _ 8 and CD4 / CD _ 8 were slightly increased and the ratio of CD3 / CD _ 4, NK / CD _ 8 and CD4 / CD _ 8 were slightly lower than those before operation at 6 months after operation.The ratio of CD3 / CD _ 4, NK and CD4 / CD _ 8 in the experimental group was significantly higher than that before operation, and the ratio of CD3 / CD _ 4, NK and CD4 / CD _ 8 was significantly lower than that of before operation at 3 months after operation, and the ratio of NK and CD4 / CD _ 8 was significantly higher than that before operation.At 6 months after operation, CD3 CD4, NK ratio and CD4 / CD8 ratio increased slightly, and CD3 T 4, NK ratio and CD4 / CD8 ratio slightly increased and CD8 ratio decreased slightly.The data of the two groups were higher than that of the control group in 1 month and 3 months after operation, and the difference was not statistically significant at 6 months and 12 months after operation, which was slightly higher than that in the control group.The clinical symptoms of the patients after operation were as follows: the patients in the combined treatment group with obvious improvement in general fatigue accounted for 14 / 16, while the control group had 46.7 / 7 / 15; the treatment group with obvious improvement of weight loss accounted for 75 / 912 / 12, while the control group with 46.15% / 13 / 13; the group with significantly improved anorexia accounted for 84.61 / 13 / 15, while the control group with 41.67 / 5 / 12; and the control group with pain in the liver area.The significant remission group accounted for 75 / 11 / 13 and the control group 42.85 / 14.The survival rates of the experimental group and the control group at 3 months, 6 months and 12 months after operation were 100.00,91.31% and 100.0069.60% respectively. The difference was statistically significant (P 0.05).Conclusion:1. The changes of immune function in patients treated with TACE alone were significantly enhanced at one month after treatment, and the immune function was not changed significantly after 12 months compared with that before treatment.2the immune function of the patients treated with TACE combined with HIFU ablation was significantly enhanced after 1 and 3 months of TACE treatment, and the immune function was the same as that of the simple TACE treatment group at 6 and 12 months after the treatment.3 the effect of TACE combined with HIFU ablation on improving clinical symptoms and improving survival rate of patients with liver cancer was better than that of TACE alone.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R735.7;R445.1

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