CIK联合手术治疗原发性肝癌的生活质量分析

发布时间：2018-04-25 16:20

本文选题：CIK细胞 + 原发性肝癌　；参考：《西安医学院》2017年硕士论文

【摘要】：目的评估CIK联合手术治疗原发性肝癌的生活质量改善前情况,分析生活质量评分(QOL)、生化指标、肿瘤标志物及功能状态KPS评分作为治疗原发性肝癌的临床依据,来探索生物免疫治疗CIK联合传统治疗方式手术能否成为治疗肝癌的最佳组合方式。方法选取2015年至2016年确诊“原发性肝癌”就诊于西安医学院附属第二附属医院、陕西省人民医院及西安交通大学第一附属医院的患者,并且给予肝癌患者行根治性切除术。将所收集到的60例原发性肝癌患者,分为实验组和对照组,其中实验组30例,在行肝癌根治切除术后,给予CIK细胞免疫治疗;对照组30例,只行肝癌根治切除术,术后不予CIK治疗。两组患者经过不同的治疗方式后从对患者的生活质量进行QOL评分(包括精神状态、食欲、睡眠质量及疼痛等)、肝功能指标(包括谷草谷丙转氨酶、总胆红素、白蛋白)及肿瘤标志物指标AFP(甲胎蛋白)下降程度和功能状态(KPS评分)等综合评估比较。结果经过一个周期的治疗后,实验组的生活质量评分(QOL)高于对照组。两组患者一般情况均较治疗前好转,食欲、精神状态、睡眠质量、疲乏等均有所改善,疼痛减轻的患者相比对照组有明显增多,差异有统计学意义(P=0.0050.05)。实验组和对照组术前谷草转氨酶分别为(70.273±20.752)U/L、(77.600±38.561)U/L,经过治疗后谷草转氨酶分别降为(47.423±17.270)U/L、(65.033±39.175)U/L,实验组比对照组下降明显,差异是有统计学意义的(P0.05)。同样,实验组与对照组术前谷丙转氨酶分别为(72.873±12.532)U/L、(98.533±74.031)U/L,经过治疗后谷丙转氨酶分别降为(46.613±16.239)U/L、(75.533±41.780)U/L,实验组比对照组下降明显,差异具有统计学意义(P0.05);实验组与对照组术前总胆红素分别为(28.283±3.693)umol/L、(27.153±3.483)umol/L,经治疗后总胆红素分别为(15.863±4.138)umol/L、(21.377±5.451)umol/L,实验组比对照组下降明显,差异具有统计学意义(P0.05);实验组与对照组术前白蛋白分别为(32.273±2.720)g/L、(32.867±3.471)g/L,经治疗后白蛋白分别为(40.847±4.290)g/L、(36.797±4.708)U/L,实验组比对照组升高显著,差异具有统计学意义(P0.05);实验组术前AFP(490.42±121.26)ng/ml、(418.47±179.86)ng/ml,经治疗后AFP分别为(294.98±111.56)ng/ml、(390.51±184.49)ng/ml,实验组与对照组在行CIK治疗前AFP(P=0.0740.05)差异无统计学意义,实验组较对照组下降明显,差异具有统计学意义(P0.05)。功能状态KPS评分,实验组与对照组治疗前无统计学意义,治疗后结果显示:实验组改善有25例,稳定有5例,0恶化,对照组改善有14例,稳定有16例,0恶化,实验组较对照组明显改善,差异有高度统计学意义(P0.05)。结论本研究结果表明CIK细胞联合手术治疗原发性肝癌对于患者生活质量的提高是有效的,可以改善患者生活质量评分(QOL)(精神状态、食欲、睡眠质量、生活质量及疼痛等)、降低生化指标及肿瘤标志物AFP,并提高功能状态评分(KPS)。
[Abstract]:Objective to evaluate the quality of life (QOL) of patients with primary liver cancer (HCC) treated by CIK combined with surgery, and to analyze the QOL scores, biochemical indexes, tumor markers and functional KPS scores as the clinical basis for the treatment of HCC. To explore whether CIK combined with traditional therapy can be the best combination in the treatment of liver cancer. Methods patients with "primary liver cancer" were selected from the second affiliated Hospital of Xi'an Medical College, the people's Hospital of Shaanxi Province and the first affiliated Hospital of Xi'an Jiaotong University from 2015 to 2016. Sixty patients with primary liver cancer were divided into experimental group and control group. The experimental group (30 cases) received CIK cell immunotherapy after radical hepatectomy, while the control group (30 cases) received radical hepatectomy. CIK was not accepted after operation. QOL scores (including mental state, appetite, sleep quality and pain), liver function index (including alanine aminotransferase, total bilirubin, etc. Albumin) and AFP (alpha-fetoprotein) decreased degree and functional state (KPS score) were compared. Results after a period of treatment, the QOLs of the experimental group were higher than that of the control group. The general conditions of the two groups were better than before treatment, appetite, mental state, sleep quality, fatigue and so on. The patients with pain relief were significantly increased compared with the control group, the difference was statistically significant. The preoperative glutamic oxalacetic transaminase in the experimental group and the control group were 77.600 卤38.561U / L, 77.600 卤38.561U / L, respectively. After treatment, the glutamic oxaloacetic transaminase decreased to 47.423 卤17.270U / L 65.033 卤39.175U / L, the difference was statistically significant (P 0.05). Similarly, the preoperative alanine aminotransferase levels in the experimental group and the control group were 72.873 卤12.532U / L and 98.533 卤74.031U / L, respectively. After treatment, the levels of alanine aminotransferase (alt) decreased to 46.613 卤16.239U / L (75.533 卤41.780UL / L), respectively. The total bilirubin in the experimental group and the control group was 28.283 卤3.693um / L respectively 27.153 卤3.483um / L, and the total bilirubin after treatment was 15.863 卤4.138m / L = 21.377 卤5.451umol/ L, respectively, which was significantly lower in the experimental group than in the control group. The difference was statistically significant (P < 0.05), the preoperative albumin of the experimental group and the control group were 32.273 卤2.720 g / L, 32.867 卤3.471g / L, respectively. After treatment, the albumin levels were 40.847 卤4.290 g / L, 36.797 卤4.708U / L, respectively, which were significantly higher in the experimental group than in the control group. The difference was statistically significant (P < 0.05), the AFP(490.42 of the experimental group was 418.47 卤179.86 ng / ml before CIK treatment, and the AFP after treatment was 294.98 卤111.56 ng / ml (390.51 卤184.49 ng / ml). There was no significant difference between the experimental group and the control group before CIK treatment (0.0740.05), but the difference in the experimental group was significantly lower than that in the control group, and the difference was statistically significant. There was no significant difference in KPS score between the experimental group and the control group before treatment. The results showed that there were 25 cases of improvement, 5 cases of stable deterioration, 14 cases of improvement and 16 cases of stable deterioration after treatment in the experimental group and the control group. Compared with the control group, the experimental group was significantly improved, the difference was statistically significant (P 0.05). Conclusion the results of this study indicate that the combined operation of CIK cells is effective in improving the quality of life of patients with primary liver cancer, and can improve the quality of life score of patients with QOL (mental state, appetite, sleep quality). Quality of life (QOL), pain and so on, decreased the biochemical indexes and tumor markers AFP, and improved the score of functional state.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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