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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。
Objective To investigate the clinical value of transcatheter arterial chemoembolization (TACE) combined with ultrasonically guided percutaneous transluminal microwave coagulation (PMCT) in the treatment of primary hepatocellular carcinoma (PHC). Methods 48 patients with PHC were divided into two groups, treated with TACE combined with PMCT (group A) and TACE (group B). Before and after treatment, T cell subsets in PHC tissues were determined. Tumor size was checked by color Doppler ultrasound on a regular basis and liver function and AFP were detected. The survival time of 6,12,18 months after operation was compared between the two groups. Results After treatment, the effective rate of A group was higher than that of B group (88.6% vs.66.7%) (P <0.05); the disappearance rate of tumor blood flow in A group was higher than that of B group (95.8% vs.33.3% (2.86 ± 0.82)% vs (4.16 ± 1.42)%] (P <0.05). The CD8 + T cells in group A were significantly higher than that in group B (12.76 ± 3.46)% vs. (7.89 ± 2.53)%] (P <0.05). The 6, 12 and 18-month survival rates in group A were 91.7%, 75.0% and 37.0%, respectively, while those in group B were 70.8%, 37.5% and 20.8% respectively. Conclusion TACE combined with PMCT in the treatment of PHC is safe, minimally invasive and effective.