超声引导下经皮微波消融治疗原发性肝癌患者疗效分析*

目的 探讨超声引导下经皮微波消融联合胸腺素-α1治疗原发性肝癌（PLC）患者的疗效。方法 2011年3月~2013年3月我院收治的PLC患者104例,随机分为观察组52例和对照组52例。对照组采用超声引导下经皮微波消融术治疗,观察组于术后皮下注射胸腺素-α1 4周。比较治疗前和治疗后外周血T淋巴细胞亚群、肝功能、甲胎蛋白（AFP）水平变化和两组肿瘤复发或转移及3年生存情况。结果 在治疗4周时,观察组外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺比值分别为71.49±6.57%、43.12±2.89%、15.89±3.24,显著高于对照组的43.21±3.74%、24.56±2.36%、5.42±2.13 （P<0.05）;观察组血清白蛋白（ALB）为39.84±2.56 g/L,显著高于对照组的34.12±1.87 g/L,丙氨酸氨基转移酶 （ALT）、天门冬氨酸氨基转移酶（AST）、AFP水平分别为34.87±3.08 U/L、43.39±2.08 U/L、85.42±10.42 μg/L,显著低于对照组的61.39±3.64 U/L、56.74±3.46 U/L、164.29±14.35 μg/L;随访3年,观察组肿瘤复发率和转移率分别为30.8%和15.4%,显著低于对照组的50.0%和32.7%（P<0.05）,观察组生存率为23.1%（12/52）,显著高于对照组的5.8%（3/52,P<0.05）。结论 超声引导下经皮微波消融后继续接受α-1胸腺素治疗PLC患者效果显著,可降低肿瘤复发或转移,延长生存时间,值得研究。

Ultrasound-guided percutaneous microwave ablation and thymosin α-1 treatment in patients with primary liver cancer

Objective To investigate the efficacy of ultrasound-guided percutaneous microwave ablation and thymosin α-1 treatment in patients with primary liver cancer （PLC）. Methods A total of 104 patients with PLC were admitted to our hospital between March 2011 and March 2013 and they were randomly divided into observation group（n=52） and control group（n=52）. The patients in control group were treated with ultrasound-guided percutaneous microwave ablation,and the ones in observation group were given subcutaneously with thymosin-α1. Results At the end of 4 week treatment,the CD3⁺ and CD4⁺ cells and the ratio of CD4⁺/CD8⁺ were 71.49±6.57%,43.12±2.89% and 15.89±3.24,significantly higher than 43.21±3.74%,24.56±2.36% and 5.42±2.13 in the control（P<0.05）;the liver function index and serum alpha-fetoprotein levels in the observation group improved or decreased significantly than in the control（P<0.05）;the complication occurrence in the observation group was 7.7%,not statistically significantly different with 11.5% in the control（P>0.05）;all patients were followed-up for 3 years,and the recurrence and metastasis in the observation group were 30.8% and 15.4%,much lower than 50.0% and 32.7% in the control（P<0.05）;the 3 a survival rate in the observation group was 23.1% （12/52）,much higher than 5.8% （3/52,P<0.05） in the control group. Conclusion Ultrasound-guided percutaneous microwave ablation followed by thymosin-α1 injection in the treatment of patients with PLC is efficient, with lower recurrence and metastasis and prolongation of survival,which warrants further investigation.