| Objective:Prospectively analyze and compare the changes of cellular immune status,short-term efficacy and safety of primaryhepatocellular carcinoma after DEB-TACE and cTACE.Materials and Methods:Patients in our hospital with primary hepatocellular carcinoma who met the inclusion criteria were studied from January 2017 to June2018.All thesepatients received transcatheter arterial chemoembolization in our hospital,a total of 78 cases.The experimental group(33 patients)received DEB-TACE treatment with drug-loaded microspheres,while the control group(45 patients)received c TACE treatment.In the two groups,T lymphocyte subsets were examined within 1 week before surgery and 1 month after surgery,respectively,and liver enhanced CT or enhanced MR examinations were performed 1 week before surgery,1 month aftersurgery and 3 months after surgeryrespectively,and simultaneous blood biochemical examinations were examined.Follow-up imaging and clinical data were collected,and m RICIST was used to evaluate the efficacy of solid tumors.Finally,the changes of cellular immune status,short-term efficacy and safety of primary hepatocellular carcinoma after DEB-TACE and c TACE were prospectively analyzed and compared.Results:1.There were no statistically significant differences between the two groups in age,gender,tumor clinical stage,liver function(Child-Pugh grading),ECOG physical strength score and others baseline data.2.The clinical staging of primary hepatocellular carcinoma was positively correlated with preoperative CD3~+%and CD3~+CD4~+%,with statistical significance,but not with CD4~+/CD8~+ratio.3.The postoperative CD3~+%,CD3~+CD4~+%andCD4~+/CD8~+%in the DEB-TACE group were all higher than those before the surgery,while the postoperative CD3~+CD8~+%was lower than that before the surgery,and the difference was statistically significant(P<0.05).Postoperative CD3~+CD4~+%and CD4~+/CD8~+in the c TACE group were higher than those before surgery,while CD3~+%and CD3~+CD8~+%were lower than those before surgery,with statistically significant differences(P<0.05).4.The frequency of CD3~+%increased by 1.8%after DEB-TACE,and decreased by 1.7%after c TACE.The difference of CD3~+%frequency between the two groups(t=3.742,P<0.001)was statistically significant.After DEB-TACE,the frequency of CD3~+CD4~+%increased by 11.1%,higher than the 3.7%increase inc TACE group,and the difference(t=2.818,P=0.006)was statistically significant.CD3~+CD8~+%(t=0.009,P=0.993),CD4~+/CD8~+(t=1.775,P=0.079)and AFP(t=1.194,P=0.236)showed no significant difference before and after surgery.5.There was a positive correlation between 1 month postoperative evaluation and postoperative CD3~+%changes,and the correlation was statistically significant,but there was no correlation with the variation of CD3~+CD4~+%,CD3~+CD8~+%and CD4~+/CD8~+.There was a positive correlation between 3 months postoperative evaluation and postoperative CD3~+%,CD3~+CD4~+%changes,and the correlation was statistically significant,butthere was no correlation with the variation of CD3~+CD8~+%and CD4~+/CD8~+.6.There was no significant difference in liver function(Child-Pugh grading)and ECOG score before and after the two types of TACE.7.The median intraoperative radiation dose and interquartile spacing of patients undergoing DEB-TACE surgery were 719.4(500.1),higher than 500.1(568.6)in the c TACE group,and the difference was statistically significant(Z=3.413,P=0.001).Conclusion:1.Both DEB-TACEtreatment and c TACE treatment can improve the cellular immune status of patients with hepatocellular carcinoma,with no statistically significant difference in terms of treatment effect.However,the frequency expression range of CD3~+%and CD3~+CD4~+%in patients afterDEB-TACE surgery is better thanthat in patients after c TACE surgery.2.There was no statistical difference in the efficacy evaluation between the DEB-TACE group and the c TACE group 1month after surgery,but the efficacy evaluation of DEB-TACE 3 months after surgery is better than that of the c TACE group,and the difference wasstatisticallysignificant.3.There was no statistical difference in safety between the DEB-TACEtreatment and the c TACE treatment,but the response of patients after c TACE surgery was stronger than that of patients after DEB-TACE treatment. |
PDF Full Text Request