经皮穿刺肝动脉栓塞化疗治疗肝癌的效果观察及对患者肿瘤标记物CA199、AFP和CEA的影响
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摘要
目的:探究经皮穿刺肝动脉栓塞化疗(THACE)治疗肝癌的效果及对患者肿瘤标记物CA199、AFP和CEA的影响。方法:将2014年9月-2016年1月本院收治的64例肝癌患者作为研究对象,所有患者(92个病灶)均接受THACE治疗。于治疗前后检测患者肿瘤标记物[糖类抗原(CA199)、甲胎蛋白(AFP)、癌胚抗原(CEA)],以及T细胞亚群水平(CD4~+T细胞、CD8~+T细胞),并采用CT、MRI或B超检查病情,评定临床疗效。结果:THACE治疗肝癌的临床总有效率为90.22%(83/92)。与治疗前比较,治疗后患者的CA199、AFP及CEA均显著下降,CD4~+T细胞水平显著下降,CD8~+T细胞水平显著上升,差异均有统计学意义(P<0.05)。结论:THACE治疗肝癌效果确切,可有效改善T细胞亚群水平并降低CA199、AFP及CEA水平,值得推广。
Objective:To investigate the effect of percutaneous transhepatic arterial chemoembolization(THACE) in the treatment of liver cancer and its influence on tumor markers CA199,AFP and CEA.Method:Sixty-four patients with HCC were enrolled in this study from September 2014 to January 2016,all patients(92 lesions) underwent THACE treatment.The tumor markers[carbohydrate antigen(CA199), alpha fetoprotein(AFP),carcinogenicity antigen(CEA)],and T cell subsets(CD4~+T cells,CD8~+T cells) were detected before and after treatment,and the clinical efficacy was evaluated by CT,MRI or B ultrasonically.Result:The total effective rate of THACE in the treatment of liver cancer was 90.22%(83/92).Compared before treatment,the CA199,AFP and CEA were significantly decreased in all patients after treatment,the levels of CD4~+T cells was significantly decreased,and the levels of CD8~+T cells was significantly increased,the differences were statistically significant(P<0.05).Conclusion:THACE is effective in the treatment of liver cancer,can effectively improve the level of T cell subsets,and reduce the levels of CA199, AFP and CEA, so it is worthy of promotion.
Objective:To investigate the effect of percutaneous transhepatic arterial chemoembolization(THACE) in the treatment of liver cancer and its influence on tumor markers CA199,AFP and CEA.Method:Sixty-four patients with HCC were enrolled in this study from September 2014 to January 2016,all patients(92 lesions) underwent THACE treatment.The tumor markers[carbohydrate antigen(CA199), alpha fetoprotein(AFP),carcinogenicity antigen(CEA)],and T cell subsets(CD4~+T cells,CD8~+T cells) were detected before and after treatment,and the clinical efficacy was evaluated by CT,MRI or B ultrasonically.Result:The total effective rate of THACE in the treatment of liver cancer was 90.22%(83/92).Compared before treatment,the CA199,AFP and CEA were significantly decreased in all patients after treatment,the levels of CD4~+T cells was significantly decreased,and the levels of CD8~+T cells was significantly increased,the differences were statistically significant(P<0.05).Conclusion:THACE is effective in the treatment of liver cancer,can effectively improve the level of T cell subsets,and reduce the levels of CA199, AFP and CEA, so it is worthy of promotion.
引文
[1]郭斌,吴增城,张宪光,等.肝动脉栓塞化疗治疗肝癌的应用进展[J].中华肝胆外科杂志,2016,22(2):137-141.
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[6]王晓维,付守忠,戴锋,等.肝动脉栓塞化疗联合射频消融与联合微波消融治疗原发性肝癌的疗效和安全性比较[J].介入放射学杂志,2016,25(8):673-676.
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[8]林清,黄念,赵志恒,等.华蟾素注射液联合肝动脉栓塞化疗治疗原发性肝癌的Meta分析[J].湖北中医药大学学报,2016,18(1):62-67.
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[10]谭冠,沈世强,秦峰,等.肝动脉栓塞化疗联合微波消融与单纯手术切除对小肝癌疗效比较[J].腹部外科,2016,29(2):101-104.
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[12]曹亮,李伟,盛俊,等.中晚期肝癌肝动脉栓塞化疗是否联合过继T细胞免疫疗法的疗效比较[J].武警医学,2014,25(4):331-335.
[13]李金燕,白星,任欣乐,等.吉西他滨联合奥沙利铂经肝动脉栓塞化疗治疗中晚期肝癌的临床疗效[J].中华实用诊断与治疗杂志,2014,28(5):509-510.
[14]张弢,段学章,张军华,等.重组人血管内皮抑制素(恩度)联合肝动脉栓塞化疗术(TACE)治疗中晚期肝癌的临床疗效评价[J].现代生物医学进展,2014,14(34):6664-6666.
[15]李嘉妍,宋金云,王建芳,等.AFP、CA19-9、CEA联合检测对原发性肝癌的早期诊断价值[J].临床肝胆病杂志,2017,33(7):1291-1295.
[16]林洁.持续腹腔热灌注化疗对肝癌晚期患者肿瘤标记物CA199、AFP及CEA的影响[J].中国医药科学,2016,6(131):226-228.
[17]笪荣峰,赵丽云,李玉红,等.复方氨基酸对肝硬化患者肝功能及AFP、CA199和CEA水平的影响[J].现代生物医学进展,2016,16(10):1898-1900.
[18]吴鹤,吕素珍,应晓珍,等.中药辅助对肝癌放疗患者机体免疫力恢复的影响[J].中华中医药学刊,2015,33(8):1997-1999.
[19]刘江伟,黄建钊,孙倩,等.射频消融术对原发性肝癌患者外周血淋巴细胞亚群的影响[J].中国普外基础与临床杂志,2015,22(10):1171-1174.
[20]方大正,吴红伟,武伦,等.肝癌患者CD8+CD28-Foxp3+调节性T细胞的变化及意义[J].中国普通外科杂志,2017,26(7):870-876.
[21]王永正,刘斌,王武杰,等.CT引导下经皮穿刺置管负压引流治疗TACE术后肝脓肿[J].中国现代普通外科进展,2014,17(12):974-977.
[22]芮强,何震宇.Lnc RNA与mi RNA的交互作用及调控机制对肿瘤发生与发展过程的影响[J].医学综述,2015,21(9):1594-1596.
[2]秦文俊,徐细明.利卡汀联合肝动脉栓塞化疗治疗中晚期肝癌的效果及安全性的系统评价[J].中国医药导报,2016,13(25):46-50,63.
[3]杨秉辉,夏景林.“原发性肝癌的临床诊断与分期标准”及说明[J].肿瘤,2002,22(1):75.
[4]张学成,贺选,王永锋,等.肝动脉栓塞化疗联合立体定向放射治疗原发性肝癌的疗效分析[J].现代肿瘤医学,2016,24(21):3437-3440.
[5]李燕,贾勋超,张希.鸦胆子油口服乳液联合肝动脉栓塞化疗治疗肝癌临床疗效以及对患者血浆内毒素及血管内皮生长因子水平影响研究[J].陕西医学杂志,2016,45(7):892-893,896.
[6]王晓维,付守忠,戴锋,等.肝动脉栓塞化疗联合射频消融与联合微波消融治疗原发性肝癌的疗效和安全性比较[J].介入放射学杂志,2016,25(8):673-676.
[7]陈丽.抗癌平丸联合肝动脉栓塞化疗术治疗中晚期肝癌临床研究[J].中医学报,2016,31(1):23-25.
[8]林清,黄念,赵志恒,等.华蟾素注射液联合肝动脉栓塞化疗治疗原发性肝癌的Meta分析[J].湖北中医药大学学报,2016,18(1):62-67.
[9]官明.肝动脉栓塞化疗联合经皮微波消融对中晚期肝癌的疗效[J].肝脏,2016,21(12):1054-1056.
[10]谭冠,沈世强,秦峰,等.肝动脉栓塞化疗联合微波消融与单纯手术切除对小肝癌疗效比较[J].腹部外科,2016,29(2):101-104.
[11]赵剑.香菇多糖对肝癌患者经导管肝动脉栓塞化疗术后血浆内毒素及VEGF水平的影响[J].海南医学院学报,2015,21(3):372-374.
[12]曹亮,李伟,盛俊,等.中晚期肝癌肝动脉栓塞化疗是否联合过继T细胞免疫疗法的疗效比较[J].武警医学,2014,25(4):331-335.
[13]李金燕,白星,任欣乐,等.吉西他滨联合奥沙利铂经肝动脉栓塞化疗治疗中晚期肝癌的临床疗效[J].中华实用诊断与治疗杂志,2014,28(5):509-510.
[14]张弢,段学章,张军华,等.重组人血管内皮抑制素(恩度)联合肝动脉栓塞化疗术(TACE)治疗中晚期肝癌的临床疗效评价[J].现代生物医学进展,2014,14(34):6664-6666.
[15]李嘉妍,宋金云,王建芳,等.AFP、CA19-9、CEA联合检测对原发性肝癌的早期诊断价值[J].临床肝胆病杂志,2017,33(7):1291-1295.
[16]林洁.持续腹腔热灌注化疗对肝癌晚期患者肿瘤标记物CA199、AFP及CEA的影响[J].中国医药科学,2016,6(131):226-228.
[17]笪荣峰,赵丽云,李玉红,等.复方氨基酸对肝硬化患者肝功能及AFP、CA199和CEA水平的影响[J].现代生物医学进展,2016,16(10):1898-1900.
[18]吴鹤,吕素珍,应晓珍,等.中药辅助对肝癌放疗患者机体免疫力恢复的影响[J].中华中医药学刊,2015,33(8):1997-1999.
[19]刘江伟,黄建钊,孙倩,等.射频消融术对原发性肝癌患者外周血淋巴细胞亚群的影响[J].中国普外基础与临床杂志,2015,22(10):1171-1174.
[20]方大正,吴红伟,武伦,等.肝癌患者CD8+CD28-Foxp3+调节性T细胞的变化及意义[J].中国普通外科杂志,2017,26(7):870-876.
[21]王永正,刘斌,王武杰,等.CT引导下经皮穿刺置管负压引流治疗TACE术后肝脓肿[J].中国现代普通外科进展,2014,17(12):974-977.
[22]芮强,何震宇.Lnc RNA与mi RNA的交互作用及调控机制对肿瘤发生与发展过程的影响[J].医学综述,2015,21(9):1594-1596.