原发性肝癌患者微波消融治疗后外周血T淋巴细胞亚群的变化

Changes in peripheral T lymphocyte subsets in patients underwent microwave ablation for primary liver cancer

目的观察原发性肝癌患者微波消融治疗前后外周血T淋巴细胞亚群的变化。方法 152例原发性肝癌患者在微波消融治疗前1d、治疗后1 w和4 w,以流式细胞术检测患者外周血CD4+和CD8+淋巴细胞数量,采用全自动生化免疫分析仪检测甲胎蛋白水平。术后1 m进行肝脏CT增强扫描观察。结果在微波消融治疗后1 w和4 w,患者外周血CD4+T淋巴细胞上升至(26.5±3.8)%和(32.3±5.1)%,CD4+/CD8+比值上升至(1.12±0.43)和(1.51±0.40),而CD8+T淋巴细胞下降至(47.2±7.7)%和(28.1±7.3)%,与治疗前1d时基线水平[CD4+、CD8+和CD4+/CD8+分别为(21.4±4.1)%、(58.6±7.8)%和(0.98±0.45)]比,变化有统计学意义(P均<0.05);甲胎蛋白水平由基线水平[(1109±727)ng/ml]下降,术后1w和4w分别为(890±681)ng/ml和(215±18)ng/ml(P<0.01);微波消融后1m行增强CT检查,示病灶完全灭活率为97.4%(148/152)。结论微波消融治疗使原发性肝癌患者外周血T淋巴细胞亚群向CD4+T淋巴细胞优势转变,可能对治疗效果的取得发挥了作用。

Objective To investigate the changes of peripheral T lymphocyte subsets in patients with prima-ry liver cancer （PLC）underwent microwave ablation. Method 152 patients with PLC were recruited and received microwave ablation treatment. One day before,and 1 week and 4 weeks after the treatment,the distributions of peripheral T lymphocyte subsets were determined by flow cytometry,and serum levels of alpha fetoprotein were measured by a automatic biochemical immune analyzer. Contrast-enhanced CT scans were performed in all pa-tients one month after the treatment. Results The percentages of CD4＋ or CD8＋T lymphocytes and the ratio of CD4＋/CD8＋in this series one day before the treatment were （21.4±4.1）%,（58.6±7.8）% and（0.98±0.45）,respective-ly,while the percentages of CD4＋T lymphocytes increased to （26.5±3.8）% and（32.3±5.1）%,and the CD4＋/CD8＋ra-tio increased to（1.12 ±0.43）and（1.51 ±0.40）,but CD8＋T lymphocytes decreased to（47.2 ±7.7）% and （28.1 ±7.3）%, respectively （P〈0.05）one week and 4 weeks after microwave ablation; serum alpha fetoprotein levels were signifi-cantly decreased from the baseline [（1109±727） ng/ml] to （890±681） ng/ml 1 week or （215±18） ng/ml 4 weeks after ablation （P〈0.01）;contrast-enhanced CT scans revealed a complete ablation rate of 97.37%（148/152） for tumors one month after therapy. Conclusions Microwave ablation for PLC shifts the distribution of peripheral blood T lym-phocyte subsets toward a CD4＋ cells-favorite status,which might play a role in improving the efficacy of the therapy.