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目的比较手术与射频消融两种治疗方法对小肝癌的治疗效果及对细胞免疫功能影响的差别。方法2004年1月至2008年1月本院原发性肝癌患者58例,随机分为射频消融组与手术组,手术治疗组行肝癌根治术,射频消融治疗组采用经皮穿刺进行射频消融治疗,观察两组治疗前后血清胰岛素样生长因子-Ⅱ(IGFⅡ-)、血管内皮细胞生长因子(VEGF)和甲胎蛋白(AFP)与CD3+、CD4+、CD8+T细胞的变化情况。结果射频组与手术组治疗前后血清IGF-Ⅱ、VEGF和AFP含量明显下降,与手术前比较差异有统计学意义(P<0.05)。但射频组与手术组治疗后血清IGF-Ⅱ、VEGF和AFP含量比较差异无统计学意义(P>0.05)。射频组治疗前后CD3+、CD4+T细胞比例上升,CD8+T细胞比例下降,其治疗前后CD4+/CD8+比较差异有统计学意义(P<0.05)。手术组治疗前后CD3+、CD4+、CD8+T细胞比例上升,其治疗前后CD4+/CD8+比较差异有统计学意义(P<0.05)。射频组与手术组CD4+/CD8+比较差异有统计学意义(P<0.05)。结论射频消融在清除肿瘤的作用方面与手术治疗无明显差异,但在保护与改善免疫功能的作用方面强于手术治疗方法。
Objective To compare the therapeutic effects of two kinds of treatment and radiofrequency ablation on small hepatocellular carcinoma (HCC) and their effects on cellular immune function. Methods From January 2004 to January 2008, 58 patients with primary liver cancer in our hospital were randomly divided into radiofrequency ablation group and operation group. Radical ablation was performed by radiofrequency catheter ablation in radiofrequency ablation group The changes of serum insulin-like growth factor-Ⅱ (IGFⅡ-), vascular endothelial growth factor (VEGF), alpha-fetoprotein (AFP) and CD3 +, CD4 + and CD8 + T cells were observed before and after treatment. Results The levels of serum IGF-Ⅱ, VEGF and AFP in RF group and operation group decreased significantly compared with those before operation (P <0.05). However, there was no significant difference in serum IGF-Ⅱ, VEGF and AFP levels between RF group and operation group (P> 0.05). The ratio of CD3 + and CD4 + T cells increased and the proportion of CD8 + T cells decreased in RF group before and after treatment. The difference of CD4 + / CD8 + before and after treatment was statistically significant (P <0.05). The proportion of CD3 +, CD4 + and CD8 + T cells increased in the operation group before and after treatment, and the difference of CD4 + / CD8 + before and after treatment was statistically significant (P <0.05). The difference of CD4 + / CD8 + between radiofrequency group and operation group was statistically significant (P <0.05). Conclusion Radiofrequency ablation has no significant difference with surgical treatment in removing tumor, but it is better than surgical treatment in protecting and improving immune function.