肝癌射频消融术对外周血Th1和Th2细胞因子的影响

The effect of radiofrequency ablation on the level of plasma Th1/Th2 cytokines in hepatocellular carcinoma

目的研究射频消融治疗对原发性肝癌(HCC)患者外周血中Th1、Th2细胞因子的影响。方法采集30例HCC患者射频消融前和射频消融后3或7 d和肝癌复发时的血浆,用液相芯片检测Th1、Th2细胞因子水平的变化。结果射频消融后Th1型细胞因子干扰素-γ(IFN-γ)和白细胞介素-12p40(IL-12p40)水平较消融前明显增加[IFN-γ:(101.30±78.70)pg/ml vs.(55.70±36.20)pg/ml;IL-12p40:(57.70±31.90)pg/ml vs.(18.10±16.70)pg/ml;P均<0.05)。但肝癌复发后IFN-γ和IL-12p40水平比消融后的水平明显下降[IFN-γ:(56.50±41.70)pg/ml vs.(101.30±78.70)pg/ml;IL-12p40:(18.90±16.460)pg/ml vs.(57.70±31.90)pg/ml;P均<0.05),与消融前比较无明显差异。射频消融治疗前后,Th2型细胞因子IL-4和IL-6水平未出现明显变化[IL-4:(11.33±12.70)pg/ml vs.(13.31±15.56)pg/ml;IL-6:(17.86±22.93)pg/ml vs.(24.46±28.46)pg/ml]。射频消融治疗后,Th2型细胞因子水平下降者伴随较长的复发时间间隔[(14.00±4.35)月],而Th2细胞因子水平增高的患者复发时间则相对较短[(5.06±4.26)月]。结论射频消融可短期激活Th1型免疫反应,但激活的Th1型免疫反应不能预防肝癌的复发。Th2型细胞因子水平改变与肝癌复发时间有关,监测Th2型细胞因子水平变化可能有助于预测肝癌复发。

Objective To study the effect of radiofrequency ablation（RFA） on plasma Th1/Th2 cytokines in hepatocellualr carcinoma（HCC） patients. Methods Thirty HCC patients＇ plasma were collected before RFA（time zero）, 3or 7days（3/7） after RFA,and at the time point of HCC recurrence. Liquid chip was used to detect the levels of Th1/Th2 cytokines. Results After RFA treatment, the levels of plasma interferon-γ（IFN-γ） and interleukin-12p40（IL-12p40） significantly increased compared with the time zero [IFN-γ：（101.30±78.70）pg/ml vs.（55.70±36.20）pg/ml;IL-12p40：（57.70±31.90）pg/ml vs.（18.10 ±16.70）pg/ml, P〈0.05）]. When HCC recurrence happened, the levels of plasma IFN-γ and IL-12p40 decreased compared with the level of 3/7 days after RFA[IFN-γ：（56.50±41.70）pg/ml vs.（101.30±78.70）pg/ml;IL-12p40：（18.90±16.46）pg/ml vs.（57.70±31.90）pg/ml; P〈0.05） and had no significant change compared with time zero.Compared with time zero, the level of plasma interleukin-4（IL-4） and IL-6 had no significant changes at time 3/7 days[time zero vs. time 3/7 days,IL-4：（11.33±12.70）pg/ml vs.（13.31±15.56）pg/ml;IL-6：（17.86±22.93） vs.（24.46±28.46）pg/ml].However, through analyzing the relation between the change of individual Th2 cytokines and individual recurrent time,the patients with decreased Th2 cytokines were associated with a longer interval time span of HCC recurrence [（14.00 ±4.35）months], and the patients with increased Th2 cytokines were associated with a shorter time spaninterval of HCC recur-rence[（5.06±4.26）months]. Conclusion RFA can shortly activate Th1 response; however, the activated Th1 response can not prevent HCC recurrence.The level of Th2 cytokines is related to the time of recurrence. The detection of level of Th2 cytokine is beneficial for early warning HCC recurrence.