肝癌患者动脉化疗栓塞序贯射频消融后淋巴细胞亚群及自然杀伤细胞的变化

Changes of lymphocyte subsets and natural killer cells in HCC patients treated by transcatheter arterial chemoembolization combined with sequential radiofrequency ablation

目的探讨原发性肝癌患者接受动脉化疗栓塞(TACE)序贯经皮射频消融(RFA)治疗前后淋巴细胞亚群及自然杀伤细胞的变化。方法回顾性分析2013年1月至2015年12月期间21例于江苏省肿瘤医院介入科接受TACE序贯RFA治疗的肝癌患者临床资料。流式细胞仪检测治疗前及治疗后7、14、30天时,患者外周血中CD3+、CD4+、CD8+、CD4+/CD8+及自然杀伤(natural killer,NK)细胞的动态变化。结果治疗后7天,患者外周血CD8+比率上升,但较治疗前差异无统计学意义(P>0.05),而CD4+、CD4+/CD8+下降,且较治疗前差异有统计学意义(P<0.05)。治疗后14天,CD8+比率下降,CD3+、CD4+、NK细胞的比率和CD4+/CD8+上升,但与治疗前比,差异无统计学意义(P>0.05)。治疗后30天,CD4+、NK细胞及CD4+/CD8+较治疗前有升高(P<0.05),同时CD8+下降(P<0.05)。结论原发性肝癌患者接受TACE序贯RFA治疗虽然短时间内会有一过性细胞免疫功能下降,但随时间推移,细胞免疫功能会逐渐恢复并有所增强。

Objective To evaluate the changes of lymphocyte subsets and natural killer cells in patients with primary hepatic cancer treated by transcatheter arterial chemoembolization combined with sequential radiofrequency ablation. Methods The clinical data of 21 patients with primary hepatic cancer underwent transcatheter arterial chemoembolization combined with sequential radiofrequency ablation therapy in the Department of Interventional Radiology of Jiangsu Cancer Hospital from January 2013 to December 2015 was analyzed retrospectively. The dynamic change of percentage of CD3 ＋,CD4 ＋,CD8 ＋,CD4 ＋/CD8 ＋ cells ratio as well as natural killer（NK） cells in the peripheral blood of patients were detected by flow cytometry before treatment,7,14 and 30 days after treatment. Results Seven days after treatment,the peripheral blood percentage of CD8＋ cells elevated,but there were no significant differences when compared with those before treatment（P〈0. 05）,while percentage of CD4＋ cells and ratio of CD4＋/CD8＋ were significantly decreased,compared with those before treatment（P〈0. 05）. Fourteen days after treatment,the peripheral blood percentage of CD8 ＋cells decreased,while percentage of CD3 ＋,CD4 ＋,NK cells and ratio of CD4 ＋/CD8 ＋ were elevated,but there were no significant differences when compared with those before treatment（P〈0. 05）. thirty days after treatment,the percentage of CD4＋,NK cells and ratio of CD4＋/CD8＋ were significantly elevated,while percentage of CD8＋ cells were significantly decreased than those before treatment（P〈0. 05）. Conclusions Patients with primary liver cancer received TACE combined with sequential RFA treatment will be a transient cellular immune function decline,but cellular immune function will gradually restore and enhanced.