肝细胞癌射频治疗前后淋巴细胞亚群及T细胞功能的变化  

Effect of radiofrequency ablation on cellular immune response in patients with hepatocellular carcinoma

作　　者：王艳滨[1] 吴后男[2] 严昆[1] 陈敏华[1] 柯杨[2] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院超声科,北京100036 [2]北京大学医学部,北京100083

出　　处：《中国介入影像与治疗学》2006年第2期115-121,共7页Chinese Journal of Interventional Imaging and Therapy

基　　金：北京市科技计划重大项目"用于肿瘤干预与治疗的新指标研究"基金;北京大学"985"科学研究计划项目基金资助;首都医学发展科研基金重点学科基金资助(ZD199909);北京市重大项目培育专项基金资助(Z0005190040431)

摘　　要：目的运用细胞膜表面标记和细胞内因子标记的流式细胞技术检测全血标本，从细胞数量和细胞功能两个角度，观察射频消融（RFA）治疗前后肝细胞癌（HCC）患者外周血淋巴细胞计数和T细胞功能分型的变化。方法经穿刺活检证实为HCC、进行RFA根治性治疗的26例患者为治疗组，以年龄、性别为匹配条件，同期选择正常对照26名为对照组。治疗组分别于RFA治疗前、治疗后1个月清晨空腹静脉取血。流式细胞仪测定B、NK、T、CD4^＋T、CD8^＋T细胞百分含量及单细胞水平上Th1、Th2、Tc1、Tc2功能亚群。分析两组间免疫指标的差别、分析治疗组于RFA治疗前后免疫指标的变化。结果肝细胞癌患者与正常人比较，NK细胞计数下降、CD8^＋T细胞中Tc1细胞的比例下降。射频治疗后Ⅰ类细胞比例增加，NK计数增多。其中男性、〉55岁、病理分级为Ⅰ～Ⅱ级、临床分期为Ⅰ～Ⅱ期及Child-Pugh分级为A／B的患者，射频治疗后其NK计数或Ⅰ类细胞的比例明显高于治疗前，增高的幅度分别大于女性、≤55岁患者、病理分级为Ⅲ～Ⅳ级、临床分期为Ⅲ～Ⅳ期及Child-Pugh分级为C的患者。结论本研究结果提示：RFA治疗1个月后，HCC患者的免疫指标有所提高，外周血免疫功能指标发生了变化，Ⅰ类细胞（Th1、Tc1）和NK逐渐增多，免疫抑制状态有所改善，细胞免疫功能逐渐增强。Objective To study the change of immune function in peripheral blood in hepatocellular carcinoma （HCC） patients after radiofrequency ablation （RFA）. Methods Peripheral blood samples were obtained from 26 HCC patients （patient group） before and 1 month after RFA. The peripheral blood samples were also obtained from 26 healthy individuals （control group） who were matched with patient group by age and sex. We determined the distribution of lymphocytes subsets （B, NK, T, CD4^＋ and CD8^＋ T lymphocyte） and investigated the potential of cytokines production at single-cell level by intracellular cytokine flow-cytometry. The percentage of typel cytokine （INF-γ） producing cells, or typel cells （Th1 and Tc1）, were assessed in total T-lymphocytes and CD3^＋ CD4^＋ T subset or CD3^＋ CD8^＋ T subset, respectively. So did the percentage of type2 cytokine （IL-4） producing cells, or type 2 cells （Th2 and Tc2）. Results The HCC patients showed a significant decrease in the percentage of nature killer （NK） cells and Tc1 cells in CD8^＋ T lymphocyte than control group. The increase in the proportion of typel cells （Tc1 and Th1） or NK cells count were found in patients after RFA treatment compared with their preoperative level, and the change range were significant great in the male, 〉55 years old, pathological grade Ⅰ - Ⅱ, stage Ⅰ -Ⅱ and Child-Pugh A/B subgroups. Conclusion These current data indicated that the immunosuppression in HCC patients was significantly modified after RFA treatment, especially in typel cells and NK cells count.

关 键 词：肝细胞肿瘤 射频消融 流式细胞仪 T细胞亚群 淋巴细胞亚群 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]