【作者】 郝明志； 陈强； 叶韵斌； 肖景榕； 林海澜； 吴晖； 余文昌； 张孔志； 陈起忠； 刘友晓； 郑伟生；

【Author】 Hao Ming-Zhi Chen Qiang Ye Yun-Bin Xiao Jing-Rong Lin Hai-Lan WuHui Yu Wen-Chang Zhang Kong-Zhi Chen Qi-Zhong Liu You-Xiao Zheng Wei-Sheng Department of internal medcine of Fujian Provincial Tumour Hospital, Fuzhou 350014,China Department of epidemiology of Fujian Provincial Tumour Hospital, Fuzhou 350014,China Fujian Medical University, Fuzhou 35000, China

【机构】 福建省肿瘤医院内科； 福建省肿瘤医院流行病学研究室； 福建医科大学；

【摘要】 目的:评价肝动脉栓塞化疗联合CIK细胞疗法治疗原发性肝癌的临床疗效。方法:以生存期为观察终点指标, 采用同期非随机对照研究,对2003年1月至2005年12月接受肝动脉栓塞化疗联合CIK细胞疗法的21例原发性肝癌患者,与同期单纯介入栓塞46例病人比较,观察生存期差异。所有病例均接受栓塞化疗,最少1次,最多4次,主要化疗药为FUDR、奥沙利铂、泽菲。栓塞剂选用碘化油、明胶海绵, 用量根据肿瘤血管造影决定。第1次介入治疗与第2次介入治疗间隔30天,以后根据病情适当延长治疗间隔。治疗组于介入治疗间歇期补充CIK细胞疗法。将异体外周血用淋巴细胞分离液分离,培养10天后制成的CIK细胞悬液用输血器回输。隔日回输一次,连续4次为一疗程,治疗组接受CIK细胞疗法最少1疗程,最多4疗程。结果:以性别、年龄、甲胎蛋白、乙肝病毒感染、门脉瘤栓、肝功能Child—pugh分级、临床分期、肿瘤大体分型为考察因素,比较两组的可比性,统计学处理结果显示除性别外,两组资料无统计学差异。治疗组与对照组中位生存期分别为22个月(95％C7,37)、10 个月(95％C8,12)。两组半年、1年、2年生存率分别为 85．71％、58．35％、48．62％及69．05％、32．74％、3．97％。治疗组生存期明显长于对照组,Kaplan—Meier生存曲线和 log—rank检验结果表明结果有显著性差异(P<0．05)。从 Kaplan—Meier生存曲线图可以看出,两组生存期有显著性差异。结论:肝动脉栓塞化疗联合CIK细胞疗法较单纯肝动脉检塞化疗有可能提高原发性肝癌患者的远期生存。更多还原

【Abstract】 Objective: To evaluate the value of Combined transcatheter arterial chemoembolization (TACE) and cytokine induced killers (CIK) for hepatocellular carcinoma. Methods: By using the non-random control studies, 67 patients with primary hepatocellular carcinoma during January 2003 and December 2005 were observed the survival period, of them, 21 patients received TACE and CIK therapy, and 46 received only TACE therapy. In 67 patients, regional chemotherapy consisted of Floxuridine , Oxaliplatin and Gemcitabin. Iodized oil and gelatin sponge were used as embolus, the dosage of iodized oil based on tumour blood vessels.Ev-ery case received TACE therapy one to four times.Con-trolled group received CIK therapy one to four courses after first TACE. To separate allo-peripheral blood by lymphocyte separation liquid, after nurturing 10 days, the CIK cells were transfused by transfusion device every two days, 1 course of CIK cell therapy includes consecutive 4 CIK cell transfusion. Results: Both groups were corresponding in terms of age, alpha-fetoprotein, hepatitis-B virus, portal embolus, liver function Child-pugh classification, clinical stages, tumors generally subtype factor.The median survival period of controlled group and observed group respectively is 22 months (95% C7, 37), 10 months (95%C8,12). The six-month, one year, and two years living rates were respectively 85.71%, 58.35%, 48.62% and 69.05%, 32.74% ,3.97%. The survival curve of Kaplan-Meier showed a significant difference between the two groups (P<0.05). Conclusion: Significant Long-term survival benefit from combined transcatheter arterial chemoembolization and cytokine induced killers compared to TACE therapy.更多还原