肝动脉灌注化疗栓塞联合经皮穿刺瘤内微波凝固治疗原发性肝癌

摘要

Objective To evaluate clinical value of transcatheter hepatic arterial chemoembolization (TACE) combined with percutaneous microwave coagulation therapy(PMCT) in treating primary hepatic carcinoma(PHC). Methods Fourty-eight patients with PHC were equally randomized into two groups of A (treated with TACE and PMCT) and B( treated with TACE). The expressions of T-cell subsets in PHC tissues were detected before and after treatment The size of tumor was measured by color Doppler sonography periodically. Liver function, AFP and AFP mRNA were examinated at the same times. Results Compared to group B.in group A, the effectiveness rate was higher<88. 6% vs. 66. 7%)(P<0. 05), the disppearence rate of tumor was higher(95.8% vs. 33.3%) ,the expression level of CD8+ T cells was higher.but that of CD4+ T cells was lower. The survival rates of 6 month. 12 month and 18 month of group A were 91. 7%,75.0%,37. 5%,which were 70. 8 %, 37. 5%, 20. 8% in group B,respectively. Conclusion The treatment of PHC TACE combined with PMCT is a safe, minimal invasive and effective in the patients with PHC.%目的 探讨肝动脉灌注化疗栓塞(TACE)联合超声引导经皮穿刺瘤内微波凝固(PMCT)治疗原发性肝癌(PHC)的临床价值.方法 PHC患者48例均分为两组,分别应用TACE联合PMCT治疗(A组)和TACE治疗(B组).治疗前、后测定PHC组织中T细胞亚群含量,定期行彩超检查肿瘤大小,并检测肝功能、甲胎蛋白(AFP).比较两组术后6、12、18个月生存期.结果 治疗后,A组有效率高于B组(88.6％ vs.66.7％)(P＜0.05);A组肿瘤血流消失率高于B组(95.8％ vs.33.3％) (P＜0.05);A组CD4+T细胞低于B组[(2.86±0.82)％vs.(4.16±1.42)％](P＜0.05); A组CD8+T细胞高于B组[(12.76±3.46)％vs.(7.89±2.53)％](P＜0.05).A组6、12、18个月生存率分别为91.7％、75.0％、37.0％,B组分别为70.8％、37.5％、20.8％.结论 TACE联合PMCT治疗PHC是安全、微创、有效的.