超声引导射频消融术对肝癌患者免疫功能的影响  

Effects of Radio Frequency Ablation on Immune Function of Hepatic Carcinoma Patients

作　　者：闫景彬 闫秀梅[2] 陈斌[3] 孙洪伟[4] 

机构地区：[1]浙江省温州市中西医结合医院超声科,温州325000 [2]温州医科大学附属第二医院儿科,温州325000 [3]温州医科大学附属第一医院超声科,温州325000 [4]温州医科大学附属第一医院肝胆外科,温州325000

出　　处：《浙江中西医结合杂志》2015年第3期228-232,共5页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：浙江省自然科学基金项目(No.LY12H03005)

摘　　要：目的观察射频消融术(RFA)对肝癌患者免疫功能的影响。方法 87例肝癌患者按治疗方法分为RFA组45例和手术组42例。应用流式细胞术检测两组治疗前后外周血CD3+T、CD4+T、CD8+T和CD56+NK细胞比例及CD4+/CD8+比值变化;通过细胞C3受体花环形成率(RBCC3BRR)、红细胞黏附肿瘤细胞花环率(RBC-TRR)和红细胞吸附免疫复合物花环形成率(RBC-ICR)实验检测外周血红细胞免疫功能;酶联免疫吸附试验(ELISA)检测血清Th1型细胞因子(IL-2、IFN-γ、TNF-α)含量。结果 RFA组治疗15天CD3+、CD4+T细胞、CD4+/CD8+比值和NK细胞数目与治疗前比较显著升高(P均<0.05);治疗30天上述指标继续升高(P均<0.05);手术组治疗15天后CD3+、CD4+T细胞、CD4+/CD8+比值和NK细胞数目与治疗前比较升高不显著(P>0.05),治疗30天后较治疗前显著升高(P均<0.05)。治疗30天后,两组CD8+T细胞数目较治疗前均有所下降,但差异无统计学意义(P>0.05)。RFA组治疗15天RBC-ICR与治疗前比较显著下降(P<0.05),RBC-C3b RR、RBC-TRR显著升高(P均<0.05);手术组治疗30天后上述指标才开始显著改善(P均<0.05),但与同期RFA组比较差异有统计学意义(P均<0.05)。RFA组治疗15天IL-2、IFN-γ、TNF-α浓度与治疗前比较显著升高(P均<0.05),治疗30天后上述指标继续升高(P均<0.05);手术组治疗30天后IL-2、IFN-γ、TNF-α浓度与治疗前比较显著升高(P均<0.05),但显著低于同期RFA组(P均<0.05)。结论与手术治疗相比较,RFA能更好地改善肝癌患者的淋巴细胞和红细胞免疫功能,促进Th1型细胞因子分泌,对肝癌治疗产生有益的影响。Objective To explore the effect of radio frequency ablation（RFA） on post-operative immune function of hepatic carcinoma patients. Methods Eighty seven patients with hepatic carcinoma were randomly divided into two groups： RFA group（n=45） and surgical resection group（n=42）. The percentage of CD3＋ T cells, CD4＋ T cells, CD8＋ T cells and CD56＋ NK cells and the ratio of CD4＋/CD8＋ T cells in peripheral blood of patients were determined by flow cytometry analysis. Red blood cell C3 b receptor rosette（RBC-C3 b RR）, tumor red blood cell rosette（RBC-TRR） and red blood cell immune complex rosette（RBC-ICR） were identified to detect the immune function of red blood cells. Thl type cytokines（IL-2, IFN-γ, TNF-α） in the sera were analyzed by ELISA assay.Results Compared to prior-treatment, CD3＋, CD4＋ T cells and NK cells and CD4＋/CD8＋ ratio increased significantly on D15 after RFA（all P〈0.05） and pushed up further on D30. However, they did not increase significantly on D15 after treatment in surgical group（all P〉0.05） and elevated to a significantly different level on D30 after treatment（all P〈0.05）. The percentage of CD8＋ T cells in both groups decreased on D30 after treatment, but not significantly（all P〉0.05）. On D15 after RFA, RBC-ICR decreased significantly and RBC-C3 b RR, RBC-TRR increased significantly（all P〈0.05）. However, these immunological indicators in surgical group improved significantly on D30 after treatment（all P〈0.05）, and there are significant difference in them between RFA group and surgical group（all P〈0.05）. Additionally, IL-2, IFN-γ, and TNF-α in the sera raised significantly on D15 after RFA treatment（all P〈0.05）, and they kept on increasing on D30 after RFA. The serum level of these Thl type cytokines increased significantly on D30 after surgical resection（all P〈0.05）, but lower than that in RFA group（all P〈0.05）.Conclusion Compared with surgical treatment, RFA may further improve immune

关 键 词：肝癌 射频消融术 手术治疗 免疫功能 TH1型细胞因子 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]