淋巴细胞亚群比例在原发性肝癌TACE、THPP前后动态变化的临床研究

Changes in the lymphocyte subgroup after TACE, THPP of primary hepatic carcinoma

目的:观察淋巴细胞亚群比例在原发性肝癌患者肝动脉介入+栓塞(TACE)前后及腹腔热灌注顺铂(THPP)后的动态变化。方法:治疗组(27例)在行肝动脉介入化疗+栓塞术前后及一周后行腹腔热灌注顺铂后一月,分别应用流式细胞仪(FCM)3次行淋巴细胞亚群测定,对照组(27例)也作介入前后及一月后,作3次淋巴细胞亚群测定。结果:原发性肝癌患者淋巴细胞亚群比例失调。CD4+、CD4+/CD8+、CD19+、NK+明显下降(P<0.05),CD3+、CD8+维持正常或略低下,TACE后更加剧了这种紊乱(P<0.01),CD4+、CD4+/CD8+、CD19+、NK+下降更明显(P<0.05),CD3+、CD8+变化不大。THPP后,上述CD4+、CD4+/CD8+、CD19+、NK+上升,CD3+、CD8+变化不大。表明患者机体免疫功能增强。结论:原发性肝癌患者免疫功能低下,TACE后免疫功能进一步降低。THPP后,淋巴细胞免疫功能明显增强。

Purpose: Observe the varities of lymphocyte subgroup of patients suffering from primary hepatic carcinoma ( PHC) during the treatment by hepatic arterial chemoembolization (TACE) and Hyperthemia Peritoneal Perfusion (THPP). Methods: Twenty seven patients were treated with TACE and THPP a week after TACE. We tested for lymphocyte subgroup three times with the flow cytometry (FCM) for pre-TACE, post-TACE and THPP a month later. The control group, twenty seven patients, were also tested for lymphocyte subgroup three times with the TACE. Results: The lymphocyte subgroup among the patients suffering from PHC were disordered. CD4+,CD4+/CD8+.CD19+NK+ were decreased, (P<0. 05). CD3+, CD8+.remained unchanged. Post-TACE, CD4+,CD4+.CD8+,CD19+ , NK+ decreased significently (P < 0. 05). The control group remained unchanged (P < 0. 05). Conclusions: Immunologic status of the patients with PHC were signifficently suppressed. The TACE made them lower. After the THPP, immunologic status of lymphocyte subgroup patients were increased significently.