肝癌患者TACE前后细胞免疫状态变化

Influence on patients' cellular immunity in hepatocellular carcinoma by TACE

目的:探讨经导管肝动脉化疗栓塞(TACE)治疗对原发性肝癌(HCC)患者的细胞免疫功能的影响及其对介入治疗的指导。方法:应用流式细胞仪测定35例HCC患者TACE治疗前、后外周血CD3+、CD4+、CD8+及NK细胞的活性。结果:①HCC患者TACE治疗前、后T细胞亚群及NK细胞活性有统计学意义(P<0.05);TACE对机体的细胞免疫功能有一定的抑制;②HCC患者TACE治疗后机体的免疫状态在导管超选择部位组间有统计学意义,导管至肝固有动脉组T细胞亚群与NK细胞的活性低于导管至肝左、右动脉组(P<0.05),而碘油不同用量组间无统计学意义(P>0.05)。结论:TACE治疗后HCC患者的细胞免疫功能进一步受到抑制,应适时检测免疫功能和给予免疫增强剂。

Objective:To study the influence on the patients' cellular immunity by TACE.Methods:T cell subsets(CD3,CD4,CD8)and NK cell in patients with HCC(35cases)were determined with flow cytometry before and after TACE treatment.Results:①There were significant differences between T cell subsets and NK cell in the HCC patients before and after the TACE treatment (P<0.05);②The cellular immunity in HCC patients demonstrated a direct relationship with superselective position of catheter:the activity of T cell subsets and NK cell in the group of TACE in proper hepatic artery were lower than that in left or right hepatic artery,but there was no statistical difference be-tween the cellular immunity and the Lipiodol dose.Conclusion:The activities of T cell subsets and NK cell in HCC patients are further suppressed by TACE treatment and the damage of normal hepatic tissues may interfere with the function of cellular immunity in HCC.