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目的探究射频消融(RFA)治疗前后肝癌患者外周血免疫细胞亚群及Th1/Th2细胞因子的变化及临床意义。方法选取2012年7月至2016年10月间山西医科大学第一医院收治的198例行RFA治疗的肝癌患者,于治疗前24h内、治疗后1周及1个月抽取患者肘静脉血3ml,采用流式细胞仪检测血清T细胞各亚型及细胞因子表达情况,比较治疗前后各时点患者免疫指标水平情况。结果治疗后1周及1个月,患者CD3~+、CD4~+、CD4~+/CD8~+、CTL及NK细胞水平与治疗前24h相比,均显著升高,CD8~+水平显著降低,差异均有统计学意义(均P<0.05)。治疗后1周及1个月,患者外周血Th1型γ干扰素(INF-γ)、肿瘤坏死因子-α(TNF-α)和白细胞介素-2(IL-2)水平均显著高于治疗前24h,且治疗后1个月水平显著高于治疗后1周,差异均有统计学意义(均P<0.05)。治疗前后,患者外周血Th2型白细胞介素-4(IL-4)和白细胞介素-10(IL-10)细胞因子水平比较,差异均无统计学意义(均P>0.05)。结论 RFA治疗后,可改善肝癌患者机体免疫调节功能,提高抗免疫水平。
Objective To investigate the changes of peripheral blood immune cell subsets and Th1 / Th2 cytokines in patients with hepatocellular carcinoma before and after radiofrequency ablation (RFA) and their clinical significance. Methods A total of 198 RFA-treated HCC patients admitted to the First Hospital of Shanxi Medical University from July 2012 to October 2016 were selected and 3ml elbow venous blood was drawn at 1 week and 1 month after treatment. The subtype of serum T cells and the expression of cytokines were detected by flow cytometry, and the levels of immune indexes in patients at various time points before and after treatment were compared. Results The levels of CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ +, CTL and NK cells in patients were significantly higher than those before 24h after treatment and the level of CD8 ~ + was significantly decreased , The differences were statistically significant (all P <0.05). The levels of Th1-IFN-γ, TNF-α and IL-2 in peripheral blood were significantly higher than those in the treatment group at 1 week and 1 month after treatment Before 24h, and 1 month after treatment was significantly higher than 1 week after treatment, the differences were statistically significant (P <0.05). Before and after treatment, there were no significant differences in the levels of Th2 IL-4 and IL-10 between the two groups (all P> 0.05). Conclusion After RFA treatment, it can improve the immunoregulatory function of patients with liver cancer and improve the anti-immunity level.