本文選題：CIK細(xì)胞 + 原發(fā)性肝癌��； 參考：《西安醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的評估CIK聯(lián)合手術(shù)治療原發(fā)性肝癌的生活質(zhì)量改善前情況,分析生活質(zhì)量評分(QOL)、生化指標(biāo)、腫瘤標(biāo)志物及功能狀態(tài)KPS評分作為治療原發(fā)性肝癌的臨床依據(jù),來探索生物免疫治療CIK聯(lián)合傳統(tǒng)治療方式手術(shù)能否成為治療肝癌的最佳組合方式。方法選取2015年至2016年確診“原發(fā)性肝癌”就診于西安醫(yī)學(xué)院附屬第二附屬醫(yī)院、陜西省人民醫(yī)院及西安交通大學(xué)第一附屬醫(yī)院的患者,并且給予肝癌患者行根治性切除術(shù)。將所收集到的60例原發(fā)性肝癌患者,分為實驗組和對照組,其中實驗組30例,在行肝癌根治切除術(shù)后,給予CIK細(xì)胞免疫治療;對照組30例,只行肝癌根治切除術(shù),術(shù)后不予CIK治療。兩組患者經(jīng)過不同的治療方式后從對患者的生活質(zhì)量進(jìn)行QOL評分(包括精神狀態(tài)、食欲、睡眠質(zhì)量及疼痛等)、肝功能指標(biāo)(包括谷草谷丙轉(zhuǎn)氨酶、總膽紅素、白蛋白)及腫瘤標(biāo)志物指標(biāo)AFP(甲胎蛋白)下降程度和功能狀態(tài)(KPS評分)等綜合評估比較。結(jié)果經(jīng)過一個周期的治療后,實驗組的生活質(zhì)量評分(QOL)高于對照組。兩組患者一般情況均較治療前好轉(zhuǎn),食欲、精神狀態(tài)、睡眠質(zhì)量、疲乏等均有所改善,疼痛減輕的患者相比對照組有明顯增多,差異有統(tǒng)計學(xué)意義(P=0.0050.05)。實驗組和對照組術(shù)前谷草轉(zhuǎn)氨酶分別為(70.273±20.752)U/L、(77.600±38.561)U/L,經(jīng)過治療后谷草轉(zhuǎn)氨酶分別降為(47.423±17.270)U/L、(65.033±39.175)U/L,實驗組比對照組下降明顯,差異是有統(tǒng)計學(xué)意義的(P0.05)。同樣,實驗組與對照組術(shù)前谷丙轉(zhuǎn)氨酶分別為(72.873±12.532)U/L、(98.533±74.031)U/L,經(jīng)過治療后谷丙轉(zhuǎn)氨酶分別降為(46.613±16.239)U/L、(75.533±41.780)U/L,實驗組比對照組下降明顯,差異具有統(tǒng)計學(xué)意義(P0.05);實驗組與對照組術(shù)前總膽紅素分別為(28.283±3.693)umol/L、(27.153±3.483)umol/L,經(jīng)治療后總膽紅素分別為(15.863±4.138)umol/L、(21.377±5.451)umol/L,實驗組比對照組下降明顯,差異具有統(tǒng)計學(xué)意義(P0.05);實驗組與對照組術(shù)前白蛋白分別為(32.273±2.720)g/L、(32.867±3.471)g/L,經(jīng)治療后白蛋白分別為(40.847±4.290)g/L、(36.797±4.708)U/L,實驗組比對照組升高顯著,差異具有統(tǒng)計學(xué)意義(P0.05);實驗組術(shù)前AFP(490.42±121.26)ng/ml、(418.47±179.86)ng/ml,經(jīng)治療后AFP分別為(294.98±111.56)ng/ml、(390.51±184.49)ng/ml,實驗組與對照組在行CIK治療前AFP(P=0.0740.05)差異無統(tǒng)計學(xué)意義,實驗組較對照組下降明顯,差異具有統(tǒng)計學(xué)意義(P0.05)。功能狀態(tài)KPS評分,實驗組與對照組治療前無統(tǒng)計學(xué)意義,治療后結(jié)果顯示:實驗組改善有25例,穩(wěn)定有5例,0惡化,對照組改善有14例,穩(wěn)定有16例,0惡化,實驗組較對照組明顯改善,差異有高度統(tǒng)計學(xué)意義(P0.05)。結(jié)論本研究結(jié)果表明CIK細(xì)胞聯(lián)合手術(shù)治療原發(fā)性肝癌對于患者生活質(zhì)量的提高是有效的,可以改善患者生活質(zhì)量評分(QOL)(精神狀態(tài)、食欲、睡眠質(zhì)量、生活質(zhì)量及疼痛等)、降低生化指標(biāo)及腫瘤標(biāo)志物AFP,并提高功能狀態(tài)評分(KPS)。
[Abstract]:Objective to evaluate the quality of life (QOL) of patients with primary liver cancer (HCC) treated by CIK combined with surgery, and to analyze the QOL scores, biochemical indexes, tumor markers and functional KPS scores as the clinical basis for the treatment of HCC. To explore whether CIK combined with traditional therapy can be the best combination in the treatment of liver cancer. Methods patients with "primary liver cancer" were selected from the second affiliated Hospital of Xi'an Medical College, the people's Hospital of Shaanxi Province and the first affiliated Hospital of Xi'an Jiaotong University from 2015 to 2016. Sixty patients with primary liver cancer were divided into experimental group and control group. The experimental group (30 cases) received CIK cell immunotherapy after radical hepatectomy, while the control group (30 cases) received radical hepatectomy. CIK was not accepted after operation. QOL scores (including mental state, appetite, sleep quality and pain), liver function index (including alanine aminotransferase, total bilirubin, etc. Albumin) and AFP (alpha-fetoprotein) decreased degree and functional state (KPS score) were compared. Results after a period of treatment, the QOLs of the experimental group were higher than that of the control group. The general conditions of the two groups were better than before treatment, appetite, mental state, sleep quality, fatigue and so on. The patients with pain relief were significantly increased compared with the control group, the difference was statistically significant. The preoperative glutamic oxalacetic transaminase in the experimental group and the control group were 77.600 鹵38.561U / L, 77.600 鹵38.561U / L, respectively. After treatment, the glutamic oxaloacetic transaminase decreased to 47.423 鹵17.270U / L 65.033 鹵39.175U / L, the difference was statistically significant (P 0.05). Similarly, the preoperative alanine aminotransferase levels in the experimental group and the control group were 72.873 鹵12.532U / L and 98.533 鹵74.031U / L, respectively. After treatment, the levels of alanine aminotransferase (alt) decreased to 46.613 鹵16.239U / L (75.533 鹵41.780UL / L), respectively. The total bilirubin in the experimental group and the control group was 28.283 鹵3.693um / L respectively 27.153 鹵3.483um / L, and the total bilirubin after treatment was 15.863 鹵4.138m / L = 21.377 鹵5.451umol/ L, respectively, which was significantly lower in the experimental group than in the control group. The difference was statistically significant (P < 0.05), the preoperative albumin of the experimental group and the control group were 32.273 鹵2.720 g / L, 32.867 鹵3.471g / L, respectively. After treatment, the albumin levels were 40.847 鹵4.290 g / L, 36.797 鹵4.708U / L, respectively, which were significantly higher in the experimental group than in the control group. The difference was statistically significant (P < 0.05), the AFP(490.42 of the experimental group was 418.47 鹵179.86 ng / ml before CIK treatment, and the AFP after treatment was 294.98 鹵111.56 ng / ml (390.51 鹵184.49 ng / ml). There was no significant difference between the experimental group and the control group before CIK treatment (0.0740.05), but the difference in the experimental group was significantly lower than that in the control group, and the difference was statistically significant. There was no significant difference in KPS score between the experimental group and the control group before treatment. The results showed that there were 25 cases of improvement, 5 cases of stable deterioration, 14 cases of improvement and 16 cases of stable deterioration after treatment in the experimental group and the control group. Compared with the control group, the experimental group was significantly improved, the difference was statistically significant (P 0.05). Conclusion the results of this study indicate that the combined operation of CIK cells is effective in improving the quality of life of patients with primary liver cancer, and can improve the quality of life score of patients with QOL (mental state, appetite, sleep quality). Quality of life (QOL), pain and so on, decreased the biochemical indexes and tumor markers AFP, and improved the score of functional state.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.7

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