超声引导肝恶性肿瘤射频消融术与手术切除对细胞免疫影响的对比研究

Comparison of cellular immunity in hepatic malignant tumors treated by ultrasound-guided radio frequency ablation and surgical resection

目的探讨超声引导下射频消融术与手术切除术对肝癌患者外周血T淋巴细胞亚群的影响。方法应用流式细胞仪检测,30例以射频消融为治疗方式和30例以手术切除为治疗方式的原发性肝癌患者的术前、术后T淋巴细胞亚群的变化。结果射频组术后10d和20d外周血中CD3+、CD4+、CD4+/CD8+水平均明显高于术前水平,CD8+明显低于术前,差异均有统计学意义(均P<0.05),且持续时间较长。手术组外周血中CD3+、CD4+、CD4+/CD8+水平明显低于术前水平,CD8+明显高于术前,差异均有统计学意义(P<0.05)。射频组术后10 d和20 d外周血中CD3+、CD4+、CD4+/CD8+均明显高于手术组,CD8+明显低于手术组,差异均有统计学意义(均P<0.05)。结论射频消融治疗肝癌患者细胞免疫功能增强,手术治疗则免疫细胞功能下降。射频消融在保护与改善细胞免疫功能方面强于手术治疗方法。

Objective To study the influence of ultrasound-guided radio frequency ablation and surgical resection of primary hepatoeellular carcinoma on T lymphocyte subsets in the peripheral blood. Methods T lymphocytes in the peripheral blood of patients in the two groups （30 patients treated by radio frequency ablation and 30 treated by surgical resection） were assayed by flow cytometry. Results 10 d and 20 d after the treatment,the levels of CD3＋ and CD4＋T lymphocytes of the radio frequency ablation group were increased, the level of CD8＋ T lymphocyte was decreased, CD4＋/CD8＋ ratio was increased, and the difference was significant （P〈0.05）, and these persistented for a long time. The levels of CD3＋ and CD4＋ T lymphocytes of the surgical resection group were decreased, the level of CD8CF lymphocyte was increased, CD4＋/CD8＋ ratio was decreased （P〈0.05）. 10 d and 20 d after the treatment,the level of CD3＋, CD4＋ T lymphocytes and CD4＋/CD8＋ ratio of the radio frequency ablation group were higher than those of the surgical resection group, and the level of CD8＋ lymphocyte was lower, the difference was significant（P〈0.05 ）. Conclusion Radio frequency ablation improves the immune suppression and enhances the cellular immune function, while surgical resection decreases the cellular immune function. Radio frequency ablation is better than surgical resection in protecting and improving the cellular immune function.