原发性肝癌患者微波消融治疗后外周血T淋巴细胞亚群的变化-论文.pdf

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1、实用肝脏病杂志2014年i月第l7卷第i期JPracHepatolJa【1．20l4．Vo1．17N—o．1·71··肝癌·原发性肝癌患者微波消融治疗后外周血T淋巴细胞亚群的变化阚晓，潘家超，荆燕，都晓伟，史兆章，韩绍磊，张海涛，郑昭敏【摘要】目的观察原发性肝癌患者微波消融治疗前后外周血T淋巴细胞亚群的变化。方法152例原发性肝癌患者在微波消融治疗前1d、治疗后1w和4w，以流式细胞术检测患者外周血CD4和CD8淋巴细胞数量，采用全自动生化免疫分析仪检测甲胎蛋白水平。术后1m进行肝脏cT增强扫描观察。结果在微波消融治疗后1w和4w，患者外周血CD4"T淋巴细胞上升至

2、(26．54-3．8)％和(32．34-5．1)％，CD4~／CD8比值上升至(1．124-0．43)和(1．51±0．40)，而cD8叮淋巴细胞下降至(47．2±7．7)％和(28．1±7．3)％，与治疗前1d时基线水平[cD4、CD8和CD4~CD8+分别为(21．4±4．1)％、(58．6±7．8)％和(0．98±0．45)]比，变化有统计学意义(P均<0．05)；甲胎蛋白水平由基线水平[(11094-727)ng／m1]T降，术后1w和4w分别为(890±681)ng／ml和(215±18)ng／ml(P<0．01)；微波消融后1m行增强cT检查，示病灶完全

3、灭活率为97．4％(148／152)。结论微波消融治疗使原发性肝癌患者外周血T淋巴细胞亚群向CD4CF淋巴细胞优势转变，可能对治疗效果的取得发挥了作用。【关键词】原发性肝癌；淋巴细胞亚群；微波消融；CD47CD8DOI：10．39696．issn．1672-5069．2014．01．021ChangesinpefipherMTlymphocytesubsetsinpatientsunderwentmicrowaveablationforprimarylivercancerKanXiao，PanJiachao，,lingYan，eto1．InfectiousDisea

4、seHospital，ShandongUniversity，Jinan250021，ShandongProvince，China【Abstract】objectiveToinvestigatethechangesofperipheralTlymphocytesubsetsinpatientswithprima—rylivercancer(PLC)underwentmicrowaveablation．Method152patientswithPLCwererecruitedandreceivedmicrowaveablationtreatment．Onedaybefo

5、re，and1weekand4weeksafterthetreatment，thedistributionsofperipheralTlymphocytesubsetsweredeterminedbyflowcytometry，andserumlevelsofalphafetoproteinweremeasuredbyaautomaticbiochemicalimmuneanalyzer．Contrast—enhancedCTscanswereperformedinallpa—tientsonemonthafterthetreatment．ResultsTheper

6、centagesofCD4orCD8q"lymphocytesandtheratioofCD4+／CD8+inthisseriesonedaybeforethetreatmentwere(21．4±4．1)％，(58．6+7．8)％and(0．98_+0．45)，respective—ly，whilethepercentagesofCD4q'lymphocytesincreasedto(26．5±3．8)％and(32．3+5．1)％，andtheCD47CD8+ra—tioincreasedto(1_12+0．43)and(1．514-0．40)，butCD8CF

7、lymphocytesdecreasedto(47．2±7．7)％and(28．1±7．3)％，respectively(P<0．05)oneweekand4weeksaftermicrowaveablation；serumalphafetoproteinlevelsweresignifi—cantlydecreasedfromthebaseline[(11094-727)ng／m1]to(8904-681)ng／ml1weekor(215M8)ng／ml4weeksafterablation(P<0．01)；contrast-enhancedCTscansre