CAJ | 학술논문

目的观察超声引导下射频消融术联合树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)治疗中晚期肝细胞癌患者的临床疗效,并探讨其对患者生命质量的影响.方法选取中国医科大学普通外科2011年1月至2014年1月收治的156例诊断为中晚期肝细胞癌的患者,按照入选先后顺序随机分为观察组82例和对照组74例.两组患者均静脉输注DC-CIK免疫细胞治疗,观察组在细胞治疗的基础上行超声引导下经皮腹腔穿刺射频消融术,连续治疗6周,治疗前后用"肿瘤生命质量核心问卷(QLQ-C30)"进行评估并比较两组患者的生命质量,观察并记录治疗过程中的不良反应并评估两组患者近期及远期临床疗效.结果治疗后两组患者的QLQ-C30问卷中整体功能、特异性症状模块各个指标及整体生命质量评分均明显优于治疗前,且治疗后观察组上述指标均优于对照组,差异均有统计学意义(P<0.05);两组患者治疗过程中均出现发热、寒战伴高热、皮疹,且差异无统计学意义(P>0.05);观察组术后出现腹痛、恶心伴呕吐、肝周血肿;治疗后观察组近期临床疗效与对照组比较差异无统计学意义(P>0.05),但远期临床疗效优于对照组,且生存期长于对照组,差异均有统计学意义(P<0.05),且中位生存期长于对照组,差异有统计学意义(P<0.05).结论超声引导下射频消融术联合DC-CIK能提高中晚期肝细胞癌患者的远期临床疗效与生命质量且不良反应较少.
목적 관찰초성인도하사빈소융술연합수돌상세포-세포인자유도적살상세포(DC-CIK)치료중만기간세포암환자적림상료효,병탐토기대환자생명질량적영향.방법 선취중국의과대학보통외과2011년1월지2014년1월수치적156례진단위중만기간세포암적환자,안조입선선후순서수궤분위관찰조82례화대조조74례.량조환자균정맥수주DC-CIK면역세포치료,관찰조재세포치료적기출상행초성인도하경피복강천자사빈소융술,련속치료6주,치료전후용"종류생명질량핵심문권(QLQ-C30)"진행평고병비교량조환자적생명질량,관찰병기록치료과정중적불량반응병평고량조환자근기급원기림상료효.결과 치료후량조환자적QLQ-C30문권중정체공능、특이성증상모괴각개지표급정체생명질량평분균명현우우치료전,차치료후관찰조상술지표균우우대조조,차이균유통계학의의(P<0.05);량조환자치료과정중균출현발열、한전반고열、피진,차차이무통계학의의(P>0.05);관찰조술후출현복통、악심반구토、간주혈종;치료후관찰조근기림상료효여대조조비교차이무통계학의의(P>0.05),단원기림상료효우우대조조,차생존기장우대조조,차이균유통계학의의(P<0.05),차중위생존기장우대조조,차이유통계학의의(P<0.05).결론 초성인도하사빈소융술연합DC-CIK능제고중만기간세포암환자적원기림상료효여생명질량차불량반응교소.
Objective To investigate the clinical efficacy of radiofrequency ablation combined with dendrit-ic cells and cytokine-induced killers (DC-CIK) and its effect on quality of life in patients with advanced hepatocellular caicinoma. Methods A total of 156 patients diagnosed with advanced hepatocellular caicinoma in our hospital from Jan. 2011 to Jan. 2014 were randomly divided into observation group (82 cases) and control group (74 cases). The two groups were both treated with DC-CIK, and the observation group was additionally treated with ultrasound-guided per-cutaneous radiofrequency ablation for 6 weeks. The quality of life was assessed and compared before and after treat-ment by Core quality of life questionnaire (QLQ-C30). Adverse reactions were recorded, and the short-term and long-term clinical efficacy was assessed. Results After treatment, the overall function, indexes of specific symptom module, overall QLQ-C30 scores were significantly better than those before treatment in the two groups (P<0.05), and all the above scores after treatment in the observation group were significantly better than those in the control group (P<0.05). The two groups all showed fever, chills combined with fever, rash, with no statistically significant differenc-es (P>0.05), and the observation group showed abdominal pain, nausea and vomiting, peripheral hepatic hematoma af-ter operation. After treatment, the two groups showed no statistically significant differences in short-term clinical effi-cacy (P>0.05), but the observation group was found to had significantly better long-term clinical efficacy and longer median survival time (P<0.05). Conclusion Radiofrequency ablation combined with DC-CIK can raise the long-term clinical efficiency and improve the quality of life of patients with advanced hepatocellular caicinoma.