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目的观察射频消融(radiofrequency ablation,RFA)治疗前后原发性肝细胞癌患者淋巴细胞亚群的变化。方法收集笔者所在贵州省人民医院2011年7月至2014年12月期间经临床及肝脏穿刺组织病理学确诊为原发性肝细胞癌且自愿接受经皮肝癌射频消融治疗的70例住院患者资料。根据肝内病灶数量,将其分为单病灶组(n=41)和多病灶组(n=29),分析其RFA治疗前后免疫指标的变化。结果 1 70例患者RFA治疗后7 d及14 d外周血CD3+/CD19-、CD3+/CD4+和CD4+/CD8+T淋巴细胞比值以及NK细胞较RFA治疗前1 d明显升高,其差异均有统计学意义(P<0.05);而RFA治疗后7 d及14 d外周血CD3+/CD8+T淋巴细胞较RFA治疗前1 d有所降低,但差异无统计学意义(P>0.05)。2单病灶组和多病灶组患者RFA治疗前后外周血淋巴细胞亚群的变化趋势与上述改变类似。3多病灶组RFA治疗前后外周血CD3+/CD19-、CD3+/CD4+及CD4+/CD8+T淋巴细胞比值和NK细胞均低于单病灶组,而CD3+/CD8+T淋巴细胞比值则高于单病灶组,但差异均无统计学意义(P>0.05)。结论 RFA治疗小肝癌不仅能毁灭癌灶,还能使机体免疫功能显著改善,抗肿瘤效应增强。
Objective To observe the changes of lymphocyte subsets in patients with primary hepatocellular carcinoma before and after radiofrequency ablation (RFA). Methods The data of 70 hospitalized patients who were diagnosed as primary HCC by clinical and hepatic puncture histopathology from July 2011 to December 2014 in Guizhou Province People’s Hospital and were randomly accepted radiofrequency ablation of percutaneous liver cancer were collected. According to the number of intrahepatic lesions, we divided them into single lesion group (n = 41) and multiple lesion group (n = 29), and analyzed the changes of immunological indexes before and after RFA treatment. Results The ratio of CD3 + / CD19-, CD3 + / CD4 + and CD4 + / CD8 + T lymphocytes in peripheral blood and the number of NK cells in peripheral blood of 7 weeks and 14 days after RFA treatment in 1 70 patients were significantly higher than those before RFA treatment, with statistical differences (P <0.05). However, the level of CD3 + / CD8 + T lymphocytes in peripheral blood of 7 days and 14 days after RFA treatment was lower than that before RFA treatment, but the difference was not statistically significant (P> 0.05). The changes of peripheral blood lymphocyte subsets in patients with single and multiple lesions before and after RFA treatment were similar to those above. The ratio of CD3 + / CD19-, CD3 + / CD4 + and CD4 + / CD8 + T lymphocytes in peripheral blood and NK cells in 3 multifocal group before and after RFA treatment were lower than those in single disease group, while the ratio of CD3 + / CD8 + T lymphocytes was higher than single lesions Group, but the differences were not statistically significant (P> 0.05). Conclusion RFA treatment of small liver cancer can not only destroy the foci, but also significantly improve the immune function, anti-tumor effect increased.