介入放射学杂志
介入放射學雜誌
개입방사학잡지
JOURNAL OF INTERVENTIONAL RADIOLOGY
2014年
6期
491-495
,共5页
曾江正%刘光清%郝新宝%洪涛%张建辉%苏群豪%黄美珠%黄芬%雷俊华
曾江正%劉光清%郝新寶%洪濤%張建輝%囌群豪%黃美珠%黃芬%雷俊華
증강정%류광청%학신보%홍도%장건휘%소군호%황미주%황분%뢰준화
冷循环电极%射频消融%肝癌%调节性T细胞%受试者工作特征曲线
冷循環電極%射頻消融%肝癌%調節性T細胞%受試者工作特徵麯線
랭순배전겁%사빈소융%간암%조절성T세포%수시자공작특정곡선
cool-tip electrode%radiofrequency ablation%hepatocellular carcinoma%regulatory T cell%receiver operating characteristic curve
目的:探讨冷循环射频消融(RFA)治疗对肝癌(HCC)患者调节性T细胞(Treg)变化及其对预后的影响。方法流式细胞仪检测冷循环RFA治疗前,治疗后1、4、7和12个月后外周血Treg的变化。随访期间采用超声造影或肝脏增强CT评估疗效。采用受试者工作特征(ROC)曲线及Kaplan-Meier生存函数的方法分析Treg动态变化与肿瘤无进展生存期的关系。结果 RFA术后1个月,30例患者肿瘤缓解(TR)率93.3%(28/30),肿瘤进展(TP)率6.67%(2/30)。 RFA术前Treg(9.42±1.16)%,术后1个月(6.55±0.97)%,较术前显著下降(t=15.325,P<0.01)。经12个月随访,TR率33.3%(10/30),TP率66.7%(20/30)。 TR组术前Treg为(8.75±0.72)%,显著低于TP组(9.76±1.20)%(t=-2.448,P=0.021)。 ROC曲线表明Treg谷值以4.82%为最佳临界值时,灵敏度为90.0%,特异度为60.0%;Treg达谷时间以5.5个月为最佳临界值,灵敏度为70.0%,特异度为85.0%。采用Kaplan-Meier曲线分析表明,肝癌RFA术后Treg谷值≤4.82%的肿瘤无进展生存率优于Treg谷值>4.82%的患者;Treg达谷时间≥5.5个月的患者预后优于Treg达谷时间<5.5个月的患者,Log-rank检验分别为字2=5.207,P =0.023;字2=22.079, P <0.01。结论冷循环RFA可以下调Treg水平,并且Treg谷值及Treg达谷时间在一定程度上反映RFA治疗HCC患者的预后。
目的:探討冷循環射頻消融(RFA)治療對肝癌(HCC)患者調節性T細胞(Treg)變化及其對預後的影響。方法流式細胞儀檢測冷循環RFA治療前,治療後1、4、7和12箇月後外週血Treg的變化。隨訪期間採用超聲造影或肝髒增彊CT評估療效。採用受試者工作特徵(ROC)麯線及Kaplan-Meier生存函數的方法分析Treg動態變化與腫瘤無進展生存期的關繫。結果 RFA術後1箇月,30例患者腫瘤緩解(TR)率93.3%(28/30),腫瘤進展(TP)率6.67%(2/30)。 RFA術前Treg(9.42±1.16)%,術後1箇月(6.55±0.97)%,較術前顯著下降(t=15.325,P<0.01)。經12箇月隨訪,TR率33.3%(10/30),TP率66.7%(20/30)。 TR組術前Treg為(8.75±0.72)%,顯著低于TP組(9.76±1.20)%(t=-2.448,P=0.021)。 ROC麯線錶明Treg穀值以4.82%為最佳臨界值時,靈敏度為90.0%,特異度為60.0%;Treg達穀時間以5.5箇月為最佳臨界值,靈敏度為70.0%,特異度為85.0%。採用Kaplan-Meier麯線分析錶明,肝癌RFA術後Treg穀值≤4.82%的腫瘤無進展生存率優于Treg穀值>4.82%的患者;Treg達穀時間≥5.5箇月的患者預後優于Treg達穀時間<5.5箇月的患者,Log-rank檢驗分彆為字2=5.207,P =0.023;字2=22.079, P <0.01。結論冷循環RFA可以下調Treg水平,併且Treg穀值及Treg達穀時間在一定程度上反映RFA治療HCC患者的預後。
목적:탐토랭순배사빈소융(RFA)치료대간암(HCC)환자조절성T세포(Treg)변화급기대예후적영향。방법류식세포의검측랭순배RFA치료전,치료후1、4、7화12개월후외주혈Treg적변화。수방기간채용초성조영혹간장증강CT평고료효。채용수시자공작특정(ROC)곡선급Kaplan-Meier생존함수적방법분석Treg동태변화여종류무진전생존기적관계。결과 RFA술후1개월,30례환자종류완해(TR)솔93.3%(28/30),종류진전(TP)솔6.67%(2/30)。 RFA술전Treg(9.42±1.16)%,술후1개월(6.55±0.97)%,교술전현저하강(t=15.325,P<0.01)。경12개월수방,TR솔33.3%(10/30),TP솔66.7%(20/30)。 TR조술전Treg위(8.75±0.72)%,현저저우TP조(9.76±1.20)%(t=-2.448,P=0.021)。 ROC곡선표명Treg곡치이4.82%위최가림계치시,령민도위90.0%,특이도위60.0%;Treg체곡시간이5.5개월위최가림계치,령민도위70.0%,특이도위85.0%。채용Kaplan-Meier곡선분석표명,간암RFA술후Treg곡치≤4.82%적종류무진전생존솔우우Treg곡치>4.82%적환자;Treg체곡시간≥5.5개월적환자예후우우Treg체곡시간<5.5개월적환자,Log-rank검험분별위자2=5.207,P =0.023;자2=22.079, P <0.01。결론랭순배RFA가이하조Treg수평,병차Treg곡치급Treg체곡시간재일정정도상반영RFA치료HCC환자적예후。
Objective To investigate the changes of regulatory T cells (Treg) in patients with hepatocellular carcinoma (HCC) after ultrasound- guided percutaneous cool- tip radiofrequency ablation (RFA), and to discuss its influence on the prognosis. Methods A total of 30 patients with HCC were enrolled in this study. The percentage of Treg in peripheral blood was estimated with flow cytometry before RFA and one, 4, 7 and 12 months after RFA. During the follow-up period, the therapeutic effects were evaluated by contrast enhanced sonography or contrast enhanced CT scanning. By using the methods of receiver operating characteristic (ROC) curve and Kaplan-Meier survival function, the correlation of Treg dynamic changes with the progression-free survival time was analyzed. Results One month after RTA, the tumor response (TR) rate in the 30 patients was 93.3% (28/30), the tumor progression (TP) rate was 6.67%(2/30). The percentage of Treg before RFA was (9.42 ± 1.16)%, which decreased to (6.55 ± 0.97)% one month after RFA, the difference was statistically significant (t = 15.325, P <0.001). Twelve months after RFA, TR rate became 33.3%(10/30), and TP rate became 66.7%(20/30). The preoperative percentage of Treg of TR group was (8.75 ± 0.72)%, which was significantly lower than that of TP group (9.76 ± 1.20)%, the difference was statistically significant (t=-2.448, P=0.021). ROC curves indicated that the optimal cut-off value of Treg nadir was 4.82%, the sensitivity was 90.0% and the specificity was 60.0%. The optimal cut-off time to reach Treg nadir was 5.5 months, the sensitivity was 70.0% and the specificity was 85.0%. Kaplan-Meier curve analysis showed that after RFA the progression-free survival rate (PFS) of patients with Treg nadir ≤ 4.82% was significantly higher than that of patients with Treg nadir>4.82%. PFS of patients with reaching Treg nadir≥5.5 months was significantly higher than that of patients with reaching Treg nadir<5.5 months. Log-rank test results were字2=5.207, P=0.023; 字2=22.079, P < 0.001, respectively. Conclusion Percutaneous cool-tip radiofrequency ablation can decrease the percentage of Treg cells. Besides, Treg nadir and the time reaching Treg nadir can reflect the prognosis of HCC patients after RFA to a certain extent.