肝胆胰外科杂志2024，Vol.36Issue(1)：7-12,6.DOI:10.11952/j.issn.1007-1954.2024.01.002
胸腺肽α1对伴MVI的肝细胞癌患者解剖性肝切除术后免疫功能和预后的影响
Effects of postoperative thymosin alpha-1 treatment on immune function and prognosis in patients with hepatocellular carcinoma accompanied by microvascular invasion(MVI)after anatomical liver resection
摘要
Abstract
Objective To investigate the impact of postoperative treatment with non-specific immune modulators thymosin alpha-1(Ta1)on the immune function and prognosis in patients with hepatocellular carcinoma(HCC)accompanied by microvascular invasion(MVI)after anatomic liver resection.Methods A retrospective analysis was conducted on clinical data of 106 patients who underwent anatomic liver resection for HCC with MVI from Mar.2017 to Jun.2021 at the First People's Hospital of Neijiang.Patients were divided into the postoperative Tα1 treatment group(n=49)and postoperative conventional treatment group(n=57).The changes in peripheral blood T-lymphocyte subsets percentages and neutrophil-to-lymphocyte ratio(NLR)at 1,3,and 6 months postoperatively,the 1-year tumour recurrence rate and recurrence-free survival rate between the two groups were compared,and the prognostic factors affecting postoperative recurrence in HCC patients were analyzed.Results(1)In the Tα1 group,postoperative CD3+,CD4+,and CD4+/CD8+levels were significantly higher than those in the conventional group(F=10.336,16.541,16.397;P＜0.05).There was no statistically significant difference in postoperative CD8+between the two groups(F=0.638,P=0.426).One month postoperatively,CD3+,CD4+,and CD4/CD8+in the Tα1 group significantly increased(P＜0.05),and CD8+significantly decreased(P＜0.05).While in the conventional group,the significant increase of CD3+and CD4+(P＜0.05)and significant decrease of CD8+(P＜0.05)occurred 6 months postoperatively,CD4+/CD8+significantly increased at 3 and 6 months postoperatively(P＜0.05).(2)Compared with the conventional group,the Tα1 group showed a significantly higher rate of NLR decrease at 1,3,and 6 months postoperatively(x2=9.811,10.271,10.120;P＜0.05).(3)The 1-year tumour recurrence rate was 18.4％in the Tα1 group and 26.3％in the conventional group,with no statistically significant difference between the two groups(x2=0.950,P=0.330).(4)Compared with the conventional group,the Tα1 group demonstrated a superior recurrence-free survival rate(x2=4.348,P＜0.05).Multivariate Cox analysis revealed that postoperative Tα1 treatment was an independent prognostic factor affecting the postoperative recurrence in HCC patients(OR=0.554,95％CI 0.317-0.967,P=0.038).Conclusion By modulating the inflammation and immune status,postoperative Tα1 can enhance the recurrence-free survival rate of HCC patients complicated with MVI after anatomic liver resection,thereby can improve the overall prognosis of HCC patients.关键词
肝细胞癌/微血管侵犯/解剖性肝切除术/胸腺肽α1/T淋巴细胞亚群/中性粒细胞与淋巴细胞比值Key words
hepatocellular carcinoma/microvascular invasion/anatomical liver resection/thymosin α1/T-lymphocyte subsets/neutrophil to lymphocyte ratio分类
医药卫生引用本文复制引用
钟平勇,刘欣,牟廷刚,卿明,谢飞..胸腺肽α1对伴MVI的肝细胞癌患者解剖性肝切除术后免疫功能和预后的影响[J].肝胆胰外科杂志,2024,36(1):7-12,6.基金项目
内江市科技计划项目(Z202132). （Z202132）
