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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、形态及位置上的变化说明局部免疫功能得到了提高
Objective To evaluate the changes of local immune status after percutaneous microwave coagulation therapy in patients with liver cancer. Methods 78 cases of liver cancer patients underwent percutaneous microwave coagulation therapy. Before microwave coagulation treatment, 3 days after treatment, 17 days and 30 days under the guidance of ultrasound to take liver cancer and its surrounding liver tissue. Specimens were immunohistochemically stained for CD3, CD4 5RO, CD5 6, CD6 8 and CD20 positive cells. Results Before microwave coagulation therapy, only few CD3, CD4 5RO, CD5 6, CD6 8 and CD20 positive cells were observed in the cancerous stroma and surrounding sinusoids. Three days after microwave coagulation treatment, except for CD20 positive cells, the number of other positive cells in hepatocellular carcinoma and its surrounding liver tissues increased significantly compared with that before treatment, especially in HCC tissues. CD3, CD4 5RO and CD5 6 positive cells peaked on the 17th day after treatment. CD6 8 peaked on the 3rd day after treatment and continued to be higher than the pre-treatment level 30 days after treatment. After treatment, the infiltrating positive cells were distributed in the tumor parenchyma and its small blood vessel cavity. In addition, more immune cell infiltration was seen between the cancer cells. Conclusion The number, shape and location of local immune cells after percutaneous microwave coagulation therapy in patients with hepatocellular carcinoma show that local immune function is improved