肝癌患者经皮微波凝固治疗后局部免疫状态变化的意义(英文)

Significance of changes in local immunity in patients with hepatocellular carcinoma after percutaneous microwave coagulation therapy

目的 评价肝癌患者经皮微波凝固治疗后局部免疫状态的变化。方法 78例肝癌患者接受经皮微波凝固治疗。于微波凝固治疗前、治疗后 3天、17天及 30天在超声引导下取肝癌及其周边肝组织。标本免疫组织化学染色 ,检查CD3、CD4 5RO、CD5 6、CD6 8及CD2 0阳性细胞。结果 微波凝固治疗前仅在癌基质及癌周边的肝窦内见有少量的CD3、CD4 5RO、CD5 6、CD6 8及CD2 0阳性细胞。微波凝固治疗后 3天除CD2 0阳性细胞外 ,肝癌及其周边肝组织内其它阳性细胞数量较治疗前明显增加 ,尤以肝癌组织内增加明显。CD3、CD4 5RO、和CD5 6阳性细胞在治疗后 17天达高峰 ,CD6 8在治疗后 3天达高峰 ,并均持续至治疗后 30天仍高于治疗前水平。治疗后浸润的阳性细胞分布在肿瘤实质及其小血管腔内 ,此外 ,于癌细胞间也见有更多的免疫细胞浸润。结论 肝癌患者经皮微波凝固治疗后局部免疫细胞数量。

OBJECTIVE: To assess the local immune response in patients with hepatocellular carcinoma after percutaneous microwave coagulation therapy (PMCT). METHODS: Seventy-eight patients with hepatocellular carcinoma underwent PMCT. Both cancerous and adjacent liver tissue were taken before, and 3, 17 and 30 days after PMCT using ultrasound-guided liver biopsy. Specimens were stained by immunohistochemical techniques for detecting CD3, CD45RO, CD56, CD68, and CD20 positive cells. RESULTS: A few CD3, CD45RO, CD56, CD68 and CD20 positive cells were observed in the cancer stroma and surrounding sinusoids in liver tissue pre-PMCT. The number of immunocytes, except for CD20 positive cells, was significantly increased both within the cancer and the adjacent liver tissue, with a larger increase in tumor tissue at day 3 post-PMCT compared with pre-PMCT. These immunocytes were enlarged in size. The number of CD3, CD45RO and CD56 positive cells peaked at day 17 and CD68 positive cells peaked at days 3 post-PMCT. At day 30 post-PMCT, this increase still existed. These infiltrating immunocytes distributed in the parenchyma of the tumor, and within the lumen of small blood vessels after PMCT. In addition, more infiltrated immune cells were seen in cancer cell spaces. CONCLUSIONS: A change in immunocyte infiltration takes place in number, configuration and location after patients with HCC are treated with percutaneous microwave coagulation, suggesting that local immune function is enhanced post-PMCT.