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目的探讨重组人p53腺病毒联合肝动脉栓塞化疗术对原发性肝癌治疗效果和免疫指标的影响。方法选取2014年3月至2015年3月间四川省江油市人民医院肝胆外科收治的48例原发性肝癌患者,采用随机数字表法分为研究组和对照组。研究组患者23例,采用重组人p53腺病毒注射液肝动脉灌注联合肝动脉栓塞化疗术治疗;对照组患者25例,采用单纯肝动脉栓塞化疗术治疗。评价实体瘤治疗效果,采用流式细胞术检测T细胞亚群(CD3+、CD4+、CD8+和CD4+/CD8+)指标,同时记录不良反应。结果治疗4周后对照组患者有效率(64.0%)低于研究组(91.4%),差异有统计学意义(P<0.05)。CD3+、CD4+与CD8+水平上,与治疗前1天比较,对照组和研究组治疗后不同时间段T细胞亚群表达差异有统计学意义(P<0.01),时间段与组别交互作用差异有统计学意义(P<0.01),对照组与研究组治疗后各时间段CD4+/CD8+差异无统计学意义(P>0.05)。结论重组人p53腺病毒联合肝动脉栓塞化疗术能提高原发性肝癌患者术后免疫功能,增强抗癌效果,安全有效,优于单纯肝动脉栓塞化疗术治疗。
Objective To investigate the effect of recombinant human p53 adenovirus combined with transcatheter arterial chemoembolization on the therapeutic efficacy and immune parameters of primary liver cancer. Methods Forty-eight patients with primary liver cancer admitted to Hepatobiliary Surgery, Jiangyou People’s Hospital of Sichuan Province between March 2014 and March 2015 were randomly divided into study group and control group. Twenty-three patients in the study group were treated with recombinant adenovirus p53 injection in combination with hepatic artery perfusion and hepatic arterial chemoembolization. In the control group, 25 patients were treated with hepatic arterial chemoembolization alone. To evaluate the therapeutic effect of solid tumors, the indexes of T cell subsets (CD3 +, CD4 +, CD8 + and CD4 + / CD8 +) were detected by flow cytometry and the adverse reactions were recorded. Results The effective rate of the control group (64.0%) after 4 weeks of treatment was lower than that of the study group (91.4%), with significant difference (P <0.05). CD3 +, CD4 +, and CD8 + levels. There was significant difference in the expression of T cell subsets between the control group and the study group at different time points after treatment (P <0.01). There was significant difference in the interaction between the two groups (P <0.01). There was no significant difference in CD4 + / CD8 + between the control group and the study group at each time point after treatment (P> 0.05). Conclusions Recombinant human p53 adenovirus combined with transcatheter arterial chemoembolization can improve the immune function of patients with primary liver cancer and enhance the anticancer effect, which is safe and effective, which is superior to that of hepatic arterial chemoembolization alone.