Objective: Autologous peripheral blood stem cells (PBSC) derived from bone marrow can promote liver regeneration and improve the liver function of patients, but there are few studies on its effect on the long-term outcomes in patients with decompensated cirrhosis. Based on previous work, this study observed the clinical outcomes of PBSC treatment in patients with decompensated cirrhosis for 10 years, in order to provide more data support for the safety and efficacy of stem cells in clinical applications. Methods: Data of patients with decompensated liver cirrhosis who completed PBSC treatment in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University from August 2005 to February 2012 were included. The follow-up endpoint was death or liver transplantation, and patients who did not reach the follow-up endpoint were followed-up for at least 10 years. The patients with decompensated liver cirrhosis who met the conditions for PBSC treatment but did not receive PBSC treatment in our hospital during the same period were used as controls. Results: A total of 287 cases with decompensated liver cirrhosis had completed PBSC treatment, and 90 cases were lost to follow-up within 10 years after surgery. A total of 151 cases with complete survival follow-up data were included in the control group. There were no statistically significant differences in baseline information such as gender, age, etiological composition and liver function score between the two groups. The 10-year survival rate was higher in PBSC than control group (37.56% vs. 26.49%, P<0.05). Cholinesterase, albumin, international normalized ratio, Child-Turcotte-Pugh score, model for end-stage liver disease score, and other indicators were gradually recovered within 3 months to 1 year after PBSC treatment, and stabilized at a more desirable level in the long-term after follow-up for up to 10 years. There was no statistically significant difference in the incidence of liver cancer between the two groups (25.22% vs.31.85%, P=0.267). The age of onset of hepatocellular carcinoma was later in PBSC than control group [(56.66±7.21) years vs. (52.69±8.42) years, P<0.05]. Conclusions: This long-term observational follow-up study of more than ten years confirms that PBSC treatment can bring long-term benefits to patients with decompensated cirrhosis, with good long-term safety, thus providing more data support on the safety and efficacy of stem cells for clinical applications.
目的： 骨髓来源的自体外周血干细胞（PBSC）可以促进肝脏再生，改善患者的肝脏功能，但其对失代偿期肝硬化患者远期预后的影响研究较少。本研究在既往工作基础上，观察失代偿期肝硬化患者PBSC治疗10年的临床结局，以期为干细胞在临床应用的安全性和有效性提供更多的数据支撑。 方法： 纳入2005年8月至2012年2月在空军军医大学第一附属医院消化内科完成PBSC治疗的失代偿期肝硬化患者资料。以死亡或肝移植作为随访终点，对于未到达随访终点的患者至少随访10年。以同期在我院就诊的符合PBSC治疗条件但未行PBSC治疗的肝硬化失代偿期患者为对照。 结果： 共有287例肝硬化失代偿期患者完成了PBSC治疗，术后10年内失访患者90例。对照组共纳入了151例具有完整生存随访信息的患者。两组患者在性别、年龄、病因组成以及肝功能评分等基线信息方面差异无统计学意义。PBSC组的10年生存率高于对照组（37.56%比26.49%，P＜0.05）。胆碱酯酶、白蛋白、国际标准化比值、肝功能评分以及终末期肝病模型评分等多项指标在PBSC治疗后的3个月～1年内逐渐恢复，并在后续长达10年的随访中长期稳定在较理想的水平。两组患者在肝癌发生率（25.22%比31.85%，P=0.267）方面差异无统计学意义。PBSC组的肝癌发生年龄晚于对照组［（56.66±7.21）岁比（52.69±8.42）岁，P＜0.05］。 结论： 通过10年以上的长期随访观察研究，进一步明确了PBSC治疗能使失代偿期肝硬化患者长期获益，并且远期安全性良好，为干细胞在临床应用的安全性和有效性提供更多的数据支撑。.