小肝癌患者外周免疫状态变化及手术、射频消融治疗的影响  

Immunity of patients with small hepatocellular carcinoma and effect of surgical resection or radiofrequency ablation on it

作　　者：朱玲燕[1] 庞雄昊[2] 周嘉[3] 

机构地区：[1]中山大学生命科学学院,广州510275 [2]中山大学肿瘤防治中心 [3]南方医科大学免疫学教研室

出　　处：《山东医药》2012年第42期1-3,共3页Shandong Medical Journal

基　　金：广东省自然科学基金资助项目(S2011040003690);南方医科大学基础医学院院长基金资助项目(JCI002)

摘　　要：目的观察小肝癌患者外周免疫状态的变化及手术切除、射频消融治疗的影响。方法采用流式细胞术检测健康人及小肝癌患者手术切除和射频消融前后外周血NK细胞、T淋巴细胞亚群的比例及其CD25、perforin分子。结果小肝癌患者手术切除和射频消融前NK细胞的比例低于健康人(P均<0.05),低杀伤功能的CD56brightNK细胞亚群的比例则高于健康人(P均<0.05);手术切除肿瘤后NK细胞比例上升(P<0.05),而射频消融后CD56brightNK细胞比例降低(P<0.01)。小肝癌患者手术切除前和射频消融前CD2+5辅助性T细胞(Th细胞)的比例高于健康人(P均<0.01),手术切除或射频消融后降低(P均<0.05),但仍高于健康人(P均<0.01);与健康人相比,小肝癌患者T细胞比例升高(P<0.05),而Th细胞及杀伤性T淋巴细胞(Tc细胞)的比例、perforin+NK细胞及perforin+T淋巴细胞的比例相近(P均>0.05),手术切除或射频消融治疗后没有明显改变(P均>0.05)。结论小肝癌患者外周免疫细胞亚群比例及功能分子表达水平发生改变,手术切除或射频消融后获得一定恢复。Objective To explore the immunity of patients with small hepatocellular carcinoma （ HCC）, and the im- pact of surgical resection （SR） and radiofrequency ablation （RFA） on it. Methods The frequency of circulating natural killer （NK） cell subsets and T lymphocyte subsets and their CD25 and perforin were measured by flow cytometry. Results The proportion of NK cells was significantly lower in small HCC patients before their treatment with SR or RFA than that in healthy individuals （all P 〈 0. 05 ）, whereas the proportion of CD56bright subsets with less cytotoxic was opposite （all P 〈 0.05 ）. Small HCC patients who received SR treatment had an increased NK cell frequency （ P 〈 0.05 ）, and those re- ceived RFA treatment had a decreased CD56bright cell frequency （P 〈0. 01 ）. Compared with healthy individuals, the level of CD25 on helper T cells was significantly increased in small HCC patients before their treatment with SR or RFA （ all P 〈 0.01 ）, and decreased significantly after SR or RFA treatment （ all P 〈 0. 05 ）, but still higher than that in healthy individ- uals （ all P 〈0.01 ）. Small HCC patients had a higher level of T cells, but comparable level of helper T cells and cytotoxic T cells and the perforin expressed on NK cells or T cells than healthy individuals, neither SR nor RFA affected them. Con- clusions The proportion of circulating immunocytes and the expression of their functional molecules are altered in small HCC patients, but recovered to some extent by surgical resection or radiofrequency ablation.

关 键 词：肝肿瘤 外科手术 射频消融 免疫细胞 

分 类 号：R735.7[医药卫生—肿瘤]