微波治疗原发性小肝癌后外周血细胞免疫功能应答

Cellular Immune Function Response in Peripheral Blood in Patients with Small Primary Hepatocellular Carcinoma by Microwave Ablation

目的:研究微波消融治疗原发性小肝癌(≤5cm)对外周血细胞免疫功能影响。方法:微波消融治疗19例小肝癌患者,手术切除治疗21例。于术前、术后30min、1d及7d采外周静脉血7ml,检测CD3、CD4、CD8及CD4/CD8及肝功能。结果:与术前相比,微波组术后7d内外周血免疫细胞CD3、CD4、CD8和CD4/CD8无明显变化。而手术组术后外周血细胞免疫功能较术前降低:CD3,术后30min、1d及7d均显著降低;CD4,术后30min及1d显著降低、且较微波组显著降低,7d恢复,与术前比较无显著差异;CD8,两组之间及组内各时点之间比较均无差异;CD4/CD8,术后30min及1d较术前降低,7d恢复,与术前比较无显著差异。微波消融治疗对肝功能的损伤较手术切除小。结论:与手术切除相比,微波消融治疗原发性小肝癌创伤小,对外周血细胞免疫功能(7d内)无明显影响,有其自身特点。

Objective: To study the influence of percutaneous microwave ablation(PMA) in patients with small primary hepatocellular car-cinoma(PHC) on cellular immune function response in peripheral blood. Methods: Patients with small PHC(The maximal diameter ≤5 cm) confirmed histologically were selected for the study. Every patient had single node only and no metastasis. 19 patients were performed by PMA and 21 by surgical resection. CD3, CD4, CD6, CD4/CD8 and liver function in peripheral blood were tested before treatment just and 30 mm,1 d and 7 d after the masses were ablated/resected. Results: The immune cells(CD3, CD4, CD8and CD4/CD8) in peripheral blood were kept at the same level as pre-treatment in PMA group after treatment (within 7 d). But the immune cells were decreased in surgical resection group after surgery: CD3 was decreased 30 min, 1 d and 7 d after surgery. CD4 was decreased 30 mm and 1 d after surgery and lower than that in PMA group, and recovered to the same level as pre-treatment in 7 d. CD8 was kept at the same level as pre-treatment and there was no different between two groups. CD4/CD8 was decreased 30 mm and 1 d after surgery and recovered to the level as pre-treatment. The liver functions were decreased in bath groups and gentlier in PMA group. Conclusion: PMA does not affect the cellular immune function in peripheral blood compared to surgery, indicating that the cellular immune function can be preserved in the pre-treatment period