發(fā)布時(shí)間：2019-06-06 07:50

【摘要】：目的本課題主要分析原發(fā)性肝癌患者在經(jīng)皮微波消融治療后機(jī)體部分免疫指標(biāo)的變化及其意義,研究經(jīng)皮微波消融治療對(duì)肝癌患者機(jī)體免疫功能造成的影響,為臨床選擇合適的治療手段及判斷預(yù)后提供客觀依據(jù)。方法統(tǒng)計(jì)了2014年2月至2016年2月兩年期間,在解放軍第四0一醫(yī)院腫瘤科所進(jìn)行的經(jīng)皮微波消融治療的48例原發(fā)性肝癌患者,分別在手術(shù)之前的3天、手術(shù)之后第8天以及手術(shù)后第30天抽取外周靜脈血3毫升,分別檢測(cè)T淋巴細(xì)胞亞群、自然殺傷細(xì)胞(NK細(xì)胞)、免疫細(xì)胞亞群因子(IFN-γ、TNF-α、IL-12、IL-2、IL-10、IL-4)和炎癥細(xì)胞因子(IL-1β、IL-6、IL-8、IP-10、MCP-1/MCAF、IL-17)水平,進(jìn)行前后對(duì)照,同時(shí)比較術(shù)前3天、術(shù)后30天外周血AFP的變化情況。結(jié)果1、經(jīng)皮微波消融治療后第8天患者外周血NK細(xì)胞比例相比手術(shù)前3天明顯升高,IL-8比例較治療前顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P值分別為0.004和0.028)。2、治療后第30天外周血NK細(xì)胞、IL-12、IFN-γ、TNF-α、CD4+T/CD8+T比值水平較治療前顯著升高,差異有統(tǒng)計(jì)學(xué)意義(P值分別為0.0004、0.028、0.043、0.018、0.035),而IL-4、IL-6、調(diào)節(jié)性T細(xì)胞所占比例較治療前顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P值分別為0.019、0.008、0.0003)。3、26例患者治療前外周血AFP高于正常者,治療后第30天均有不同程度降低,治療前后外周血AFP差異有統(tǒng)計(jì)學(xué)意義(t=2.39,P0.05)。4、所有免疫細(xì)胞亞群及細(xì)胞因子治療后第8天與治療后第30天比較,差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論1、原發(fā)性肝癌患者經(jīng)皮微波消融治療后外周血NK細(xì)胞、IL-12、IFN-γ、TNF-α、CD4+T/C D8+T水平較治療前明顯提高,調(diào)節(jié)性T細(xì)胞、IL-4較治療前顯著降低提示經(jīng)皮微波消融治療可直接或間接刺激機(jī)體產(chǎn)生抗腫瘤效應(yīng),增強(qiáng)肝癌患者的細(xì)胞免疫功能。2、IL-8、IL-6、AFP治療后顯著降低,提示經(jīng)皮微波消融治療可以有效降低原發(fā)性肝癌患者腫瘤負(fù)荷且具有較好的近期療效。
[Abstract]:Objective to analyze the changes and significance of some immune indexes in patients with primary liver cancer after percutaneous microwave ablation, and to study the effect of percutaneous microwave ablation on immune function in patients with primary liver cancer. It provides an objective basis for clinical selection of appropriate treatment and prognosis. Methods from February 2014 to February 2016, 48 patients with primary liver cancer were treated by percutaneous microwave ablation in the Department of Oncology, 40th Hospital of the people's Liberation Army, respectively, three days before the operation. On the 8th day after operation and on the 30th day after operation, 3 milliliters of peripheral venous blood were taken to detect T lymphocyte subsets, natural killer cells (NK cells), immune cell subgroup factors (IFN- 緯, TNF- 偽, IL-12,IL-2,). The levels of IL-10,IL-4 and IL-1 尾 (IL-6,IL-8,IP-10,MCP-1/MCAF,IL-17) were compared before and after operation, and the changes of AFP in peripheral blood 3 days before and 30 days after operation were compared. Results 1. The proportion of NK cells in peripheral blood of patients on the 8th day after percutaneous microwave ablation was significantly higher than that on the 3rd day before operation, and the proportion of IL-8 was significantly lower than that before treatment (P = 0.004 and 0.028, respectively). On the 30th day after treatment, the ratios of IL-12,IFN- 緯, TNF- 偽 and CD4 T/CD8 T in peripheral blood NK cells were significantly higher than those before treatment (P = 0.0004, 0.028, 0.043, 0.018, 0.035, respectively), while IL-4, was significantly higher than that before treatment (P = 0.0004, 0.028, 0.043, 0.018, 0.035, respectively). The proportion of IL-6, regulatory T cells was significantly lower than that before treatment (P = 0.019, 0.008, 0.0003, respectively). 3, AFP in peripheral blood of 26 patients before treatment was higher than that of normal patients. On the 30th day after treatment, the level of AFP in peripheral blood was significantly lower than that before and after treatment (t 鈮，

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