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目的探讨应用微波消融(PMCT)联合自体CIK细胞治疗中晚期肝癌的临床价值,为中晚期肝癌的治疗提供依据。方法收集2008年1月至2011年8月收治的有完整病例资料的中晚期原发性肝癌住院患者67例,随机分为PMCT组(n=32)和PMCT+CIK联合治疗组(n=35),对两组的疗效、肿瘤坏死程度及外周血淋巴细胞亚群百分比的变化情况进行分析。结果 PMCT组与PMCT+CIK联合治疗组治疗后患者甲胎蛋白(AFP)定量明显下降(下降>50%)率分别为40.6(13/32)和65.7%(23/35),两组间差异有统计学意义(P<0.05);PMCT组的完全坏死率为15.6%(5/32),而联合治疗组的完全坏死率为40.0%(14/35),差异有统计学意义(P<0.05)。联合治疗组CIK细胞治疗后CD3+、CD4+、CD16+CD56+和CD4+/CD8+比值明显上升,CD8+效应细胞比例下降,与治疗前比较差异均有统计学意义(P<0.05),且与PMCT组比较,差异也有统计学意义(P<0.05)。结论 PMCT联合早期CIK细胞过继免疫治疗可改善患者外周血淋巴细胞比例和机体免疫状态,为不能手术切除或其他治疗效果不佳的中晚期肝癌患者提供了一种有效方法。
Objective To investigate the clinical value of microwave ablation (PMCT) combined with autologous CIK cells in the treatment of advanced hepatocellular carcinoma (HCC), and to provide evidence for the treatment of advanced hepatocellular carcinoma (HCC). Methods A total of 67 patients with advanced hepatocellular carcinoma (HCC) admitted from January 2008 to August 2011 were enrolled, and randomly divided into PMCT group (n = 32) and PMCT + CIK group (n = 35) ), The efficacy of the two groups, the degree of tumor necrosis and changes in the percentage of peripheral blood lymphocyte subsets were analyzed. Results After treatment, the AFP levels in the PMCT group and the PMCT + CIK group were significantly decreased (> 50%) and 40.6 (13/32) and 65.7% (23/35), respectively. The differences between the two groups (P <0.05). The complete necrosis rate was 15.6% (5/32) in the PMCT group and 40.0% (14/35) in the combined treatment group, with a statistically significant difference (P < 0.05). The ratio of CD3 +, CD4 +, CD16 + CD56 + and CD4 + / CD8 + in CIK cells in combination therapy group was significantly increased, and the proportion of CD8 + effector cells in CIK cells treated with combination therapy was significantly lower than that before treatment (P <0.05) The difference was also statistically significant (P <0.05). Conclusion Adoptive immunotherapy with PMCT combined with early CIK cells can improve peripheral blood lymphocyte ratio and immune status of patients and provide an effective method for patients with advanced hepatocellular carcinoma who can not be surgically removed or treated poorly.