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目的:观察多靶点抗原肽自体免疫细胞技术(multiple antigen stimulating cellular therapy,MASCITM)联合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗原发性肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效。方法:回顾性分析2010年8月至2015年3月南方医院感染内科暨肝病中心收治的66例接受TACE治疗的HCC患者,按是否联合MASCITM治疗分为联合治疗组(32例)和单纯TACE组(34例),主要观察指标为两组患者的无进展生存期(PFS)和总生存期(OS)。结果:联合治疗组0.5、1、2年无进展生存率分别为68.8%、37.5%和25.0%,单纯TACE组分别为50%、11.8%和2.9%,两组中位PFS分别为9.5和5.5个月(P<0.01)。联合治疗组0.5、1、2年的总生存率分别为81.3%、65.6%和40.6%,单纯TACE组分别为91.2%、47.1%和23.5%,两组中位OS分别为19.5个月和10.5个月(P<0.05)。是否接受MASCITM治疗、肝门静脉侵犯、治疗前AFP水平、ECOG评分是影响HCC患者PFS的独立预后因素,而是否接受MASCITM治疗、肝门静脉侵犯、治疗前总胆红素水平是影响OS的独立预后因素。结论:MASCITM联合TACE治疗可提高HCC患者的临床疗效,明显延长PFS和OS。
Objective: To observe the clinical efficacy of multiple antigen stimulating cellular therapy (MASCITM) and transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma (HCC). Methods: A retrospective analysis of 66 TCC-treated patients with HCC admitted to Southern Hospital of Infectious Diseases and Hepatitis Center from August 2010 to March 2015 was divided into combined treatment group (32 cases) and TACE group (treated with MASCITM) (34 cases). The main outcome measures were progression-free survival (PFS) and overall survival (OS) in both groups. Results: The progression-free survival rates at 0.5, 1 and 2 years in combination therapy group were 68.8%, 37.5% and 25.0% respectively, while those in pure TACE group were 50%, 11.8% and 2.9%, respectively. The median PFS were 9.5 and 5.5 Month (P <0.01). The overall survival rates at 0. 5, 1, 2 years were 81.3%, 65.6% and 40.6% in the combination group and 91.2%, 47.1% and 23.5% in the TACE alone group, respectively, with a median OS of 19.5 months and 10.5 years Month (P <0.05). Whether receiving MASCITM treatment, hepatic portal vein invasion, pre-treatment AFP level, ECOG score is an independent prognostic factor affecting PFS in patients with HCC, but whether MASCITM treatment, portal vein invasion, total bilirubin levels before treatment is an independent prognostic factor affecting OS . Conclusion: MASCITM combined with TACE can improve the clinical curative effect of HCC patients and prolong the PFS and OS significantly.