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目的探讨肝动脉灌注化疗栓塞(TACE)、超声引导经皮无水乙醇注射疗法(PEIT)联合治疗原发性肝癌(PHC)的临床应用价值及治疗前后调节性T细胞和CD8+T细胞变化。方法将38例PHC患者随机平均分为2组,2组在病情、病程、分类、年龄、性别、肿瘤大小和数量等方面差异无统计学意义。2组患者分别接受TACE及TACE联合PEIT(TACE+PEIT)治疗,所有病例于治疗前后行肝癌组织中调节性T细胞和CD8+T细胞含量测定,定期行彩色多普勒超声检查,并检测肝功能、AFP、AFPmRNA。术后对比6、12、18个月生存期,评价TACE与PEIT联合治疗的价值。结果 TACE+PEIT组肿瘤缩小有效率为84%,TACE组肿瘤缩小有效率65%,2组差异有统计学意义(P<0.05);2组治疗前后调节性T细胞和CD8+T细胞含量差异均有统计学意义(P<0.05),且2组间差异有统计学意义(P<0.05);TACE+PEIT组6、12、18个月生存率分别为90%、71%、36%。TACE组患者6、12、18个月生存率分别为73%、38%、22%。结论 TACE联合PEIT治疗PHC疗效稳定可靠。
Objective To investigate the clinical value of transcatheter arterial chemoembolization (TACE) and ultrasound-guided percutaneous ethanol injection (PEIT) in the treatment of primary hepatocellular carcinoma (PHC) and the changes of regulatory T cells and CD8+ T cells before and after treatment. Methods 38 patients with PHC were randomly divided into 2 groups. There was no significant difference in the condition, course, classification, age, gender, tumor size and number between the two groups. Two groups of patients were treated with TACE and TACE combined with PEIT (TACE+PEIT). All patients were evaluated for the content of regulatory T cells and CD8+ T cells in liver cancer before and after treatment. Color Doppler ultrasonography and liver were routinely performed. Functional, AFP, AFP mRNA. The postoperative survival period of 6, 12, and 18 months was compared to evaluate the value of combined TACE and PEIT therapy. Results The effective rate of tumor shrinkage in TACE+PEIT group was 84%, and the tumor reduction efficiency in TACE group was 65%. The difference between the two groups was statistically significant (P<0.05); the difference in the content of regulatory T cells and CD8+ T cells between the two groups before and after treatment All were statistically significant (P<0.05), and the difference between the two groups was statistically significant (P<0.05); the 6-, 12-, and 18-month survival rates of the TACE+PEIT group were 90%, 71%, and 36%, respectively. The survival rates at 6, 12, and 18 months in the TACE group were 73%, 38%, and 22%, respectively. Conclusion TACE combined with PEIT is stable and reliable in the treatment of PHC.