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目的探讨细胞因子诱导的杀伤细胞(CIK)免疫治疗联合肝动脉化疗栓塞(TACE)术治疗原发性肝癌患者的临床疗效。方法选择2012年2月~2014年2月间在本院确诊并行TACE术的67例原发性肝癌患者,按是否联合CIK治疗分为联合治疗组(CIK+TACE)32例和对照组(TACE)35例,比较两组患者外周血T淋巴细胞亚群变化、生活质量(QOL)改善、临床疗效、无进展生存期(PFS)等指标。结果在CIK首次回输后7 d,联合治疗组患者外周血CD3~+、CD4~+细胞的比例和CD4~+/CD8~+比值分别为(70.32±2.36)%、(32.18±2.27)%和(1.15±0.05),显著高于CIK细胞治疗前水平[(63.56±2.42)%、(30.34±2.05)%和(0.90±0.05),P<0.05)];CIK细胞治疗后外周血CD8+细胞比例为(29.35±2.95)%,显著低于治疗前水平[(33.28±3.14)%,P<0.05];联合治疗组患者生活质量明显改善,治疗前后Karuafsky评分分别为(74.6.±12.5)和[(83.4±14.7),P<0.05];联合治疗组部分缓解率为53.1%,与对照组42.9%比,无显著性差异(P>0.05);联合治疗组中位PFS为16个月,显著高于对照组的9.5个月(P<0.05);CIK治疗后不良反应轻微,对症处理后均恢复正常。结论 CIK细胞免疫疗法联合TACE术较单纯TACE术治疗,可以提高肝癌患者的细胞免疫功能,改善原发性肝癌患者的生存质量,延缓肿瘤进展。
Objective To investigate the clinical efficacy of cytokine-induced killer (CIK) immunotherapy combined with transcatheter arterial chemoembolization (TACE) in the treatment of patients with primary liver cancer. Methods Sixty-seven patients with primary hepatocellular carcinoma diagnosed concurrent TACE in our hospital from February 2012 to February 2014 were divided into two groups according to whether they combined with CIK: CIK + TACE (32 cases) and control group (TACE) ) 35 cases. The changes of peripheral blood T lymphocyte subsets, improvement of QOL, clinical curative effect, progression-free survival (PFS) and other indexes were compared between the two groups. Results The ratio of CD3 ~ + and CD4 ~ + cells and the ratio of CD4 ~ + / CD8 ~ + in the peripheral blood of the combination group were (70.32 ± 2.36)% and (32.18 ± 2.27)%, respectively And (1.15 ± 0.05), respectively, which were significantly higher than that of CIK cells [(63.56 ± 2.42)%, (30.34 ± 2.05)% and (0.90 ± 0.05), P < (29.35 ± 2.95)%, which was significantly lower than that before treatment [(33.28 ± 3.14)%, P <0.05]. The quality of life of patients in combined therapy group was significantly improved, Karuafsky scores before and after treatment were (74.6 ± 12.5) [(83.4 ± 14.7), P <0.05]. The partial remission rate was 53.1% in the combined treatment group and 42.9% in the control group, with no significant difference (P> 0.05). The median PFS in the combined treatment group was 16 months, Which was significantly higher than that of the control group for 9.5 months (P <0.05). Adverse reactions were mild after CIK treatment and returned to normal after symptomatic treatment. Conclusion CIK cell immunotherapy combined with TACE is more effective than TACE alone in improving the cellular immune function, improving the quality of life of patients with primary liver cancer and slowing the progression of tumors.