肝癌切除术后肝断面^(125)I粒子植入对机体免疫的影响

Immunological influence of iodine-125 implantation in patients with hepatocellular carcinoma resection

目的探讨肝癌切除术后,残肝断面125I粒子植入对机体免疫细胞组成和细胞因子分泌的影响。方法68例可手术切除的肝癌患者,随机分为手术切除及125I粒子植入组(治疗组)和单纯手术切除组(对照组)。分别用流式细胞仪和ELISA法检测手术前后两组患者外周血中的CD3+、CD4+、CD8+、NK细胞组成(单位为%)及血浆细胞因子IL-4、IL-10、IL-12、IFN-γ水平(单位为ng/L)。结果对照组:手术后第7天CD3+、CD4+百分比分别为(39.38±6.98)、(24.34±3.18),较手术前的(62.58±8.67)、(30.63±4.19)低(P<0.05);CD8+、NK水平手术前后无统计学差异(P>0.05)。术后第7天细胞因子IL-4、IL-10分别为(29.83±7.99)、(87.54±2.89),较手术前的(10.35±8.76)、(64.25±2.54)升高(P<0.05);手术前、后的IL-12和IFN-γ差异无统计学意义(P<0.05)。治疗组:手术前后的CD3+、CD4+、CD8+、NK细胞差异无统计学意义(P>0.05)。手术前、后细胞因子IL-4、IL-10差异无统计学意义(P>0.05);术后IL-12、IFN-γ分别为(89.46±11.43)、(47.78±5.45),较手术前的(36.13±9.16)、(7.14±2.17)明显升高(P<0.05)。两组比较,治疗组术后CD3+、CD4+较对照组高(P<0.05);细胞因子IL-4、IL-10水平较对照组低(P<0.05);细胞因子IL-12、IFN-γ水平较对照组高(P<0.05)。结论肝癌手术后残肝断面125I粒子植入有较强的抗肿瘤免疫刺激作用,并可促进机体免疫应答的Th2/Th1偏移。

Objective To investigate the effect of iodine-125 implantation on immune cell subsets and cytokine production in patients undergoing hepatocellular carcinoma（HCC） resection.Methods Sixty-eight patients with resectable HCC were randomly divided into intrahepatic iodine-125 embedding group and control group.The percentages of T lymphocyte phenotypes（CD3^＋,CD4^＋,CD8^＋）,NK cells,and the plasma concentrations of IL-4,IL-10,IL-12 and IFN-γ of the patients were determined with flow cytometry and ELISA,respectively.Results In the control group,the postoperative CD3^＋ and CD4＋ immunocytes were（39.38±6.98）% and（24.34±3.18）%,significantly lower than the preoperative levels [（62.58±8.67）% and（30.63±4.19）%,respectively,P〈0.05）].The postoperative concentrations of IL-4 and IL-10 were（29.83±7.99） and（87.54± 2.89） ng/L,significantly higher than the preoperative levels（10.35±8.76 and 64.25±2.54 ng/L,respectively,P〈0.05）.In the treatment group,the percentages of the immunocytes and cytokine concentrations underwent no significant changes after the operation,but postoperative IL-12（89.46±11.43 ng/L） and IFN-γ（47.78±5.45 ng/L） levels were significantly higher than the preoperative levels（36.13±9.16 and 7.14±2.17 ng/L,respectively,P〈0.05）.Significant differences were found between the two groups in the postoperative CD3^＋ and CD4^＋ immunocytes and IL-4,IL-10,IL-12 and IFN-γ levels.Conclusion Iodine-125 implantation can strongly stimulates the anti-tumor immune response in HCC patients by increasing CD3^＋ and CD4^＋ immunocytes and promoting Th2/Th1 deviation.