摘要
目的 探讨超声引导下经皮微波凝固治疗肝癌对患者局部免疫状态的影响。方法 78例经病理检查证实为肝癌并自愿接受PMCT者于治疗前 ,治疗后 3d、17d和 30d在超声引导下经皮作肝脏穿刺 ,取癌灶内及其周围肝组织做免疫组化染色 ,观察并计数癌灶内、外CD3、CD45RO、CD5 6、CD6 8和CD2 0阳性细胞数。结果 治疗前癌灶内、外有不同程度的上述细胞浸润。这些细胞主要散布于癌周的肝窦及癌基质内。治疗后 3d癌灶内、外上述阳性细胞数较治疗前明显增高 ,尤以癌灶内增加明显 ,并同治疗前患者病灶局部免疫细胞数量呈正相关 (r=0 .5 6 ,P =0 .0 13)。CD3、CD45RO和CD5 6阳性细胞在治疗后 17d达高峰 ,CD6 8阳性细胞于治疗后 3d达高峰 ,并均持续至治疗后 30d仍高于治疗前 ,并见免疫细胞移行于癌细胞间和癌灶小血管腔内。结论 PMCT能增强肝癌患者局部的免疫应答。
Objective To assess the local immune response to percutaneous microwave coagulation therapy (PMCT) for hepatocellular carcinoma (HCC). Methods Seventy eight patients with HCC underwent PMCT. Samples of cancer and adjacent liver tissues were taken at pre therapy, and 3, 17 and 30 days after therapy by ultrasound guided biopsy and were stained by immunohistochemical technique. The CD3, CD45RO, CD56, CD68 and CD20 positive cells were detected in the tissue section and counted under a microscope. Results There were some CD3, CD45RO, CD56, CD68 and CD20 positive cells scattered among the cancer stroma and sinusoids and surrounding liver tissue pre therapy. Those cells increased significantly at the third day post therapy compared with those of pre therapy both in cancer and adjacent liver tissues, except CD20 positive cells. The number of infiltrating immunocytes was related to the basic immune state of patients ( r =0.56, P =0.013). Those immunocytes scattered among the parenchymal area of the tumor, the lumen of small blood vessels and the stroma closing to small vessels. The number of CD45RO and CD56 cells reached their highest point at the day 17 and CD68 positive cells at day 3 and sustained to the day 30 after PMCT. Those immunocytes were seen among the cancer cells and the lumen of small blood vessels after. Conclusion The number of immunocytes in the lesion area is increased and the local immune function is enchanced by PMCT.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2000年第10期745-748,共4页
National Medical Journal of China
基金
国家自然科学基金!资助项目 (39770 838)
关键词
肝癌
经皮微波凝固
治疗
超声引导
Carcinoma, hepatocellular
Mricowaves
Immunity, cellular
