摘要
目的 探讨经皮局部微波热凝固治疗 (PMCT)肝癌与病灶局部细胞免疫的关系及其对预后的影响。方法 82例患者的 89个原发肝癌结节接受PMCT。其中 7例患者肝内有多发结节且其中 1个结节与第 1次治疗的主结节不在同一肝叶 ,与主结节远隔的较小癌结节在主结节治疗过程中作为对照组观察 ,观察 1 7d后再行PMCT。在超声引导下于患者PMCT前及后 1 7d时取治疗组和观察组结节组织 ,用免疫组织化学染色方法检测治疗前后癌组织内CD3+ 、CD45RO+ 、CD8+ 、CD68+ 、CD56+ 、CD2 0 + 细胞及T淋巴细胞Fas 配体。分析免疫细胞浸润程度与复发率的关系。结果 治疗组 1年和 2年肝内复发率分别为 2 0 4%和 2 8 1 %。PMCT前治疗结节和观察结节内均有少量CD3+ 、CD56+ 和CD68+ 细胞浸润。治疗结节T淋巴细胞Fas 配体阳性率为 8%。PMCT后 ,治疗结节和观察结节内免疫细胞浸润程度明显增加 ,细胞直径明显增大 ,但观察结节不如治疗结节免疫细胞变化明显。治疗组T淋巴细胞Fas 配体阳性率明显增加 ,免疫细胞浸润程度高者的 1年复发率明显低于浸润程度低者。结论 PMCT肝癌可增强病灶局部的细胞免疫功能。
Objective To evaluate cellular immunologic changes and their prognostic significance after percutaneous microwa ve coagulation therapy (PMCT) of hepatocellular carcinoma (HCC). Methods Eighty-nine nodules in eighty-two consecutive patient s underwent PMCT.The 89 nodules were divided into two groups:treatment group,wit h 82 primary nodules in 82 patients and a control group,with 7 nodules in 7 pati ents.The control nodules were not affected by microwave thermal field when the treated nodules were coagulated by microwave.The control nodules were treated a t 17 d after the treatment group treated.Specimens were taken with ultrasound-g uided liver biopsy from the treated nodule and the control nodule,pre- and pos t-PMCT.Infiltration by T lymphocytes,B lymphocytes,NK cells,macrophages and Fas -L on T lymphocytes in the tumour tissue were studied immunohistochemically usi ng a panel of monoclonal antibodies against CD3 +,CD45RO +,CD20 +,CD56 + ,CD68 + and Fas-L.The relationship between the recurrence rate and the extent of immunocytes infiltration was analyzed.Results The recurrence rate of the lst and 2nd years was 20 4% and 28 1% within the liver in treatment group,respectively.There was a few C D3 +,CD56 + and CD68 + cells′ infiltration within both treated and contr ol nodules;the expression rate of Fas-L on T lymphocytes was 8% in treated gro up before PMCT.The extent of immunocyte infiltration increased significantly in both treated and control nodules;the diameter of immunocytes enlarged after PMCT ,albeit less markedly within control nodules when compared with the treated ones .The expression rate of Fas-L on T lymphocytes was increased significantly in t reated nodules compared with the pre-PMCT one′s.The recurrence rate was lower in the patients with extensive immunocyte infiltration than that in the patients with low extent of immunocyte infiltration. Conclusion PMCT for HCC could enhance the regional cellular imm une function,this enhancement may be an immune response to the treated tumor.
出处
《中国药物与临床》
CAS
2003年第4期295-298,共4页
Chinese Remedies & Clinics
基金
国家自然科学基金资助项目(39870 794)
