原发性肝癌手术与射频消融治疗前后IGF-II、VEGF与CD4^+/CD8^+的变化研究

The research on the influence of IGF-Ⅱ、VEGF and CD4^+/CD8^+ after the operation and radio frequency ablation of primary hepatocellular carcinoma

目的:比较手术与射频消融两种治疗方法对小细胞肝癌的治疗效果及对细胞免疫功能影响的差别。方法:2004年1月～2008年1月,中南大学湘雅二医院原发性肝癌患者58例,随机分为射频消融组与手术组。手术组行肝癌根治术治疗,射频消融组采用经皮穿刺进行射频消融治疗,观察两组治疗前后血清IGF-Ⅱ、VEGF、AFP,及CD3+、CD4+、CD8+T细胞的变化情况。结果:射频组与手术组治疗前后血清IGF-Ⅱ、VEGF和AFP含量明显下降,与手术前比较有统计学意义(P<0.05)。但射频组与手术组治疗后血清IGF-Ⅱ、VEGF和AFP含量比较,差异无统计学意义(P>0.05)。射频组治疗前后CD3+、CD4+T细胞比例上升,CD8+T细胞比例下降,其治疗前后CD4+/CD8+比较,差异有统计学意义(P<0.05)。手术组治疗前后CD3+、CD4+、CD8+T细胞比例上升,其治疗前后CD4+/CD8+比较,差异有统计学意义(P<0.05)。射频组与手术组CD4+/CD8+比较,差异有统计学意义(P<0.05)。结论:射频消融在清除肿瘤的作用方面与手术治疗无明显差异,但在保护与改善免疫功能的作用强于手术治疗方法。

Objective： To study the different of radio frequency ablation and surgical resection of primary hepatocellular carcinoma on IGF- II, VEGF and CD4^＋/CD8^＋ in the peripheral blood.Methods： Fifty-eight patients were divided into two groups, one group （28 cases） treated with radio frequency ablation and other group（20 eases ） with treated operation.IGF- Ⅱ ,VEGF and CD4^＋/CD8^＋ in the peripheral blood of patients. in the two groups were assayed and the results were compared. Results： After the radio frequency ablation and operation treatment, IGF- Ⅱ ,VEGF and AFP of the two groups decreased （P〈0.05）. But there were no difference between the radio frequency ablation group and operation group after the treatment. The rate of CD3^＋, CD4^＋ in the radio frequency ablation group was increased. The rate of CD8^＋rF lymphocyte decreased ,CD4^＋/CD8^＋ increased, the difference was significant（P〈0.05）. The rate of CD3^＋, CD4^＋ and CD8^＋rF lymphocyte in the operation group was increased. CD4^＋/CD8^＋ increased （P〈0.05）. The levels of CD4^＋/CD8^＋ were significant difference be tween the radio frequency ablation group and operation group after the treatment（P〈0.05）.Conclusion： The curative effects of radio frequency ablation and operation have no difference. But radio frequency ablation improves the immune suppression and enhances the cellular immune function, while surgical resection decreases the cellular immune function.