摘要
目的:探讨自然杀伤细胞(NK细胞)辅助射频消融术治疗肝癌患者的效果及对肿瘤标志物、T细胞亚群、γ干扰素(IFN-γ)和生存率的影响。方法:选取2018年1月至2020年6月首都医科大学附属北京朝阳医院怀柔医院收治的肝癌患者82例为研究对象,采用随机数字表法分为观察组和对照组,每组41例。对照组予以腹腔镜下射频消融术治疗,观察组予以NK细胞辅助腹腔镜下射频消融术治疗。比较两组临床疗效、生存情况及消融术前、后血清肿瘤标志物〔细胞角蛋白19(CK19)、甲胎蛋白(AFP)、父系表达基因10(PEG10)〕、免疫指标〔CD4^(+)T细胞、CD4^(+)/CD8^(+)、总B淋巴细胞、NK细胞〕、NK细胞相关免疫因子〔白细胞介素-12(IL-12)、白细胞介素-10(IL-10)、γ-干扰素(IFN-γ)〕及癌症患者生命质量测定量表(FACT-G)评分。结果:观察组术后1个月总有效率(70.73%)与对照组(58.54%)相比无明显差异(P>0.05)。观察组术后1个月血清CK19、AFP、PEG10、IL-10水平均低于对照组,CD4^(+)T细胞、CD4^(+)/CD8^(+)、总B淋巴细胞、NK细胞及血清IL-12、IFN-γ水平均高于对照组(P<0.05)。观察组术后6个月FACT-G各维度评分高于对照组(P<0.05)。观察组中位总生存时间(OS)、中位无生存进展期(PFS)分别为16个月、12个月,对照组中位OS、中位PFS分别为12个月、8个月(均P<0.001)。结论:NK细胞辅助射频消融术治疗肝癌具有一定的临床效果,可纠正T淋巴亚群紊乱状态,增强机体免疫功能,调节NK细胞相关免疫因子水平,改善患者预后及生存质量。
Objective:To investigate the efficacy of natural killer cells(NK cells)assisted radio frequency ablation on patients with liver cancer,and to analyze its influence on tumor markers,T cell subsets,interferonγ(IFN-γ)and survival rate.Methods:A total of 82 patients with liver cancer admitted to Huairou Hospital,Beijing Chaoyang Hospital,Capital Medical University from January 2018 to June 2020 were selected as the research subjects and randomly divided into observation group and control group,with 41 cases in each group.The control group was treated with laparoscopic radio frequency ablation,and the observation group was treated with NK cells assisted laparoscopic radio frequency ablation.Clinical efficacy,survival,serum tumor markers[cytokeratin 19(CK19),alpha-fetoprotein(AFP),paternal expression gene 10(PEG10)],immune indicators[CD4^(+)T cells,CD4^(+)/CD8^(+),total B lymphocytes,NK cells],NK cell-related to immune factors[interleukin-12(IL-12),interleukin-10(IL-10),interferon-γ(IFN-γ)],and functional assessmen of cancer therapy-gauge(FACT-G)scores.Results:There was no significant difference in the total effective rate between the observation group(70.73%)and the control group(58.54%)at one month after operation(P>0.05).The levels of serum CK19,AFP,PEG10 and IL-10 in the observation group were all lower than those in the control group at one month after operation.The levels of CD4^(+)T cells,CD4^(+)/CD8^(+),the total B lymphocytes,NK cells,as well as serum IL-12 and IFN-γlevels in the observation group were higher than those in the control group(P<0.05).The scores of FACT-G in all dimensions in the observation group were all higher than those in the control group at 6 months after operation(P<0.05).The median overall survival time(OS)and median progression-free survival time(PFS)in the observation group were 16 months and 12 months,respectively,while the median OS and median PFS in the control group were 12 months and 8 months,respectively(both P<0.001).Conclusion:NK assisted radio frequency ablation therapy for liver cancer has certain clinical efficacy,which can correct the disorder of T lymphocyte subsets,enhance the immune function of the body,regulate the level of NK cell-related immune factors,and improve the prognosis and quality of life of patients.
作者
胡志朝
刘航
张锦纯
樊华
Hu Zhichao;Liu Hang;Zhang Jinchun;Fan Hua(Department of Hepatobiliary Surgery,Huairou Hospital,Beijing Chao-yang Hospital,Capital Medical University,Beijing 101400,China;Department of Hepatobiliary,Pancreatic and Spleen Surgery,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)
出处
《广西医科大学学报》
CAS
2023年第11期1871-1877,共7页
Journal of Guangxi Medical University
基金
北京市卫生科技发展专项基金获准资助项目(No.2017-12-528)。
关键词
肝癌
自然杀伤细胞
射频消融术
T细胞亚群
Γ干扰素
生存质量
liver cancer
natural killer cells
radio frequency ablation
T cell subsets
interferonγ
quality of life
作者简介
通信作者:樊华,E-mail:nathesl5340@21cn.com。
