超声引导下射频消融术联合靶向治疗对晚期肝细胞癌患者免疫功能的影响.pdf

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1、解放军医药杂志2015年5月第27卷第5期Med&P!：!：：!：Q·41··论著·超声引导下射频消融术联合靶向治疗对晚期肝细胞癌患者免疫功能的影响陈旭兰，付靖楠，李颖，屈波[摘要]目的探讨超声引导下射频消融术(RFA)联合靶向治疗对晚期肝细胞癌患者免疫功能的影响。方法将2011年3月一2Ol4年7月收治的晚期肝细胞癌9O例随机分为观察组和对照组，每组45例。观察组入院后行超声引导下经皮腹腔穿刺RFA1周后给予吉非替尼联合卡培他滨靶向治疗，对照组给予基础治疗1周行靶向治疗。治疗前、后均测定两组免疫细胞及体液免疫功能。结

2、果观察组治疗后4周血清CD3、CD4、CD4／CD8、CD3+CD56+NK和血清IgG、IgM、IgA浓度均较治疗前和对照组升高，CD8较治疗前和对照组降低(P<0．05)，对照组治疗后4周CD3、CD4、CD4／CD8、CD3+CD56+NK和血清IgG、IgM、IgA浓度较治疗前降低，CD8较治疗前升高(P<0．05)。结论晚期肝细胞癌患者行超声引导下RFA联合靶向治疗能很好地改善免疫功能。[关键词]癌，肝细胞；超声引导；导管消融术；靶向治疗；免疫功能[中国图书资料分类号]R735．7[文献标志码]A[文章编号]

3、2095—140X(2015)05—0041-05[DOI]10．3969／j．issn．2095．140X．2015．05．012EfectofRadiofrequencyAblationCombinedwithTargetedTherapyunderUltrasoundGuideonImmuneFunc．tionofPatientswithAdvanceHepatocellularCarcinomaCHENXu-tan“FUJing．nan，LIYing2，，QUBo(a．DepartmentofSpecialIn

4、spection，b．DepartmentofEntero—chirurgia，C．DepartmentofSurgicalOneology，1．AffiliatedHospitalofLogisticsAcademyoftheChinesePeople，sArmedPoliceForce，Tianjin300162，China；2．DepartmentofSpecialInspection，GeneralHospitalofTianjinArmedPoliceForce，Tianjin300162，China)[Ab

5、stract]ObjectiveToinvestigatetheeffectofradiofrequencyablation(RFA)combinedwithtargetedthera—PYunderultrasoundguideonimmunefunctionofpatientswithadvancedhepatocellularcarcinoma．MethodsAtotalof90patientswithadvancedhepatocellularcarcinomaduringMarch2011andJuly201

6、4wererandomlydividedintoobserva—tiongroup(n=45)andcontrolgroup(n=45)．TheobservationgroupwastreatedwithRFAunderuhrasoundguidedforoneweek，andthentargetedtherapyofGefitinibcombinedwithCapecitabinefollowed；whilethecontrolgroupwastrea．tedwithtargetedtherapyfollowingb

7、asictherapy．Theimmunefunctionindicationsofcellsandbodyfluidsweredetectedinthetwogroupsbeforeandafterthetreatment．ResultsInobservationgroup，theconcentrationsofCD3CD4，CD4／，CD8，CD3+CD56+NK，IgG，IgMandIgA4weeksafterthetreatmentweresignificantlyhigher．whiletheCD8conce

8、n．trationwassignificantlylowerthanthosebeforethetreatmentinthesamegroupandafterthetreatmentinthecontrolgroup(P<0．05)；inthecontrolgroup，theconcentrationsofCD3，CD4，CD4／