摘要目的 观察中药联合肝动脉灌注化疗栓塞术(transcatheter arterial chemoembolization,TACE)对原发性肝癌患者免疫功能的影响。方法 原发性肝癌80例被分为治疗组(中药联合TACE组,40例)和对照组(TACE组,40例)。两组均于TACE术前24 h、术后1周和4周,检查外周血T淋巴细胞亚群、CD4CD25调节性T淋巴细胞(Treg),以及AFP含量,并进行临床疗效及生活质量评分(KPS)比较。结果 治疗1周后,对照组CD3+[(45.26±2.83) vs (50.16±6.31)]、CD4+[(22.65±2.35) vs (27.12±3.36)]、CD4+/CD8+[ (0.85±0.16) VS (1.16±0.27)]较术前降低,CD8+[(32.48±6.21) vs (27.36±5.64)]及CD4+CD25+[(12.65±5.12) vs (9.15±3.63)]调节性T淋巴细胞(Treg)呈升高趋势,差异有统计学意义(P<0.05);治疗组CD3+[(46.55±3.94) vs (49.33±3.12)]、CD4+[(23.13±2.72) vs (25.53±2.52)]、CD8+[(25.26±3.52) vs (27.69±5.13)]、CD4+/CD8+[(1.13±0.39) vs (1.22±0.16)]及Treg细胞[(10.36±5.62) vs (8.20±2.25)]较治疗前变化无统计学意义(P>0.05)。治疗4周后,两组患者T细胞亚群各项指标均较术前明显改善(P<0.05),组间比较差异无统计学意义(P>0.05);Treg细胞组间比较,治疗组优于对照组[(3.96±1.32) vs (6.21±3.42)],有统计学意义(P<0.05)。AFP测定及KPS评分,治疗组均优于对照组。结论 中药联合TACE可以更好的改善原发性肝癌患者的免疫状况及生活质量。
Abstract:Objective To explore the influence of Traditional Chinese Medicine combined with transcatheter arterial chemoembolization (TACE) on immune function in primary liver cancer patients. Methods A total of 80 patients with pathologically-proved PLC were enrolled in this study, and randomly divided into a study group and a control group.The study group was treated with TCM combined TACE, while the control group was treated by TACE alone. Peripheral blood T lymphocyte subsets cells, AFP, CD4+CD25+ Treg cell, as well as the therapeutic effect, Karnofsky sore (KPS) were determined 24 h before treatment and one, and 4 weeks after treatment. The Results were statistically analyzed.Results At the end of the first week after treatment, the preoperative peripheral T lymphocyte subsets CD3+(45.26±2.83) vs (50.16±6.31), CD4+(22.65±2.35) vs (27.12±3.36) T cells and CD4+/CD8+(0.85±0.16) vs (1.16±0.27) in the study group were significantly lower,while CD8+(32.48±6.21) vs (27.36±5.64) T cells, CD4+CD25+(12.65±5.12) vs (9.15±3.63) Treg cells were significantly higher than that before treatment(P<0.05). However, in control group, the peripheral T lymphocyte subsets CD3+, CD4+, CD8+T cells and CD4+/CD8+ were not statistically significantly different. After 4 weeks,for two groups, the peripheral T lymphocyte subsets CD3+(46.55±3.94) vs (49.33±3.12), CD4+(23.13±2.72) vs (25.53±2.52), CD8+(25.26±3.52) vs (27.69±5.13) T cells and CD4+/CD8+(1.13±0.39) vs (1.22±0.16) were significantly different (P<0.05). Treg cells, AFP, KPS were statistically significantly different when compared with those in the control group (P<0.05). Conclusions TCM combined with TACE can enhance the immunity and quality of life in patients with primary liver cancer.
苗同国, 马立伟, 王立静, 陈午盛, 邵明亮, 段玉松. 中药联合TACE对原发性肝癌患者免疫功能的影响[J]. 武警医学, 2016, 27(9): 928-931.
MIAO Tongguo, MA Liwei, WANG Lijing, CHEN Wusheng, SHAO Mingliang, and DUAN Yusong. Influence of Traditional Chinese medicine combined with transcatheter arterial chemoembolization on immune function of primary liver cancer patients. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(9): 928-931.
Song P, Tang W, Tamuras S,et al. The management of hepatocellular carcinoma in Asia:a guideline combining quantitative and qualitative evaluation[J].Biosci Trends,2010,4(6):283-287.
[3]
Lencioni R. Loco-regional treatment of hepatocellular carcinoma[J].Hepatology,2010,52(2):762-773.
[4]
O’Beirne J P, Harrison P M. The role of the immune system in the control of hepatocellular carcinoma[J].Eur J Gastroenterol Hepatol,2004,16:1257-1260.