射频消融治疗前后肝癌患者外周血免疫细胞亚群及Th1/Th2细胞因子的变化

Changes in immune cell subsets and Th1/Th2 cytokines in peripheral blood in patients with hepatocellular carcinoma before and after radiofrequency ablation

目的探究射频消融(RFA)治疗前后肝癌患者外周血免疫细胞亚群及Th1/Th2细胞因子的变化及临床意义。方法选取2012年7月至2016年10月间山西医科大学第一医院收治的198例行RFA治疗的肝癌患者,于治疗前24h内、治疗后1周及1个月抽取患者肘静脉血3ml,采用流式细胞仪检测血清T细胞各亚型及细胞因子表达情况,比较治疗前后各时点患者免疫指标水平情况。结果治疗后1周及1个月,患者CD3^+、CD4^+、CD4^+/CD8^+、CTL及NK细胞水平与治疗前24h相比,均显著升高,CD8^+水平显著降低,差异均有统计学意义(均P<0.05)。治疗后1周及1个月,患者外周血Th1型γ干扰素(INF-γ)、肿瘤坏死因子-α(TNF-α)和白细胞介素-2(IL-2)水平均显著高于治疗前24h,且治疗后1个月水平显著高于治疗后1周,差异均有统计学意义(均P<0.05)。治疗前后,患者外周血Th2型白细胞介素-4(IL-4)和白细胞介素-10(IL-10)细胞因子水平比较,差异均无统计学意义(均P>0.05)。结论 RFA治疗后,可改善肝癌患者机体免疫调节功能,提高抗免疫水平。

Objective To explore the changes and clinical significance of peripheral blood immune cell subsets and Th1/Th2 cytokines in patients with hepatocellular carcinoma（ HCC） before and after radiofrequency ablation（ RFA）. Methods A total of 198 patients with HCC treated with RFA at The First Hospital of Shanxi Medical University were selected as the subjects from July 2012 to October 2016. 3 ml fasting venous blood was extracted at 24 h before treatment and 1 week and 1 month after the treatment. Flow cytometry was used to detect the expression of T cell subsets and cytokines. Changes in the immune indexes were compared before and after the treatment. Results Compared with 24 h before RFA,the level of CD3^＋,CD4^＋,CD4^＋/CD8^＋,CTL and NK cell significantly increased and the level of CD8^＋significantly decreased in the patients at 1 week and 1 month after the treatment（ all P〈0. 05）. The levels of Th1 type cytokines interferon-γ（ INF-γ）,tumor necrosis factor-α（ TNF-α） and interleukin-2（ IL-2） in peripheral blood were significantly higher at 1 week and 1 month after the treatment than those at 24 h before the treatment and the level at 1 month after the treatment was significantly higher than at 1 week after the treatment（ all P〈0. 05）. There was no significant change in the level of Th2 type cytokines interleukin-4（ IL-4） and interleukin-10（ IL-10） in peripheral blood of patients before and after treatment（ P〈0. 05）. Conclusion RFA can improve the immune regulation function and improve the immunity level in patients with hepatocellular carcinoma.