高强度聚焦超声对21例中晚期原发性肝癌病人免疫状态的影响

目的　探讨高强度聚焦超声 (highintensityfocusedultrasound ,HIFU)对原发性肝癌(hepatocellularcarcinoma,HCC)病人机体免疫状态的影响。 方法　采用重庆海扶技术有限公司研制的HIFU系统 ,治疗中晚期HCC病人 2 1例。分别在治疗前和治疗后 3、7、14、2 1d抽取病人外周静脉血 ,检测细胞免疫和体液免疫的相关指标。HIFU治疗后又行癌灶切除的病例 ,对标本进行光学显微镜、电子显微镜观察。结果　光学显微镜、电子显微镜观察结果显示 ,HIFU治疗区内癌组织发生了不可逆性损伤。CD4治疗前 (34± 13)后 (3、7、14及 2 1d分别为 4 0± 7,37± 7,39± 9,37± 7)差异无显著意义 (F =0 89,P >0 0 5 ) ;其他细胞免疫指标 (CD3 ,CD8,CD4/CD8,CD16)以及体液免疫指标(IgG ,IgA ,IgM ,C3 )治疗前后间的差异亦均无显著意义。结论　HIFU能有效地破坏HCC组织。HIFU治疗中晚期HCC病人难以明显改善机体的免疫状态 ,此时若配合免疫治疗等手段 ,有望使病人获得更好的预后。

The effect of high intensity focused ultrasound on the immunity of patient with hepatocellular carcinoma

Objective To investigate the changes of immunity in patients with hepatocellular carcinoma (HCC) treated by high intensity focused ultrasound (HIFU). Methods HIFU system was used to treat 21 patients with mid-advanced HCC. The blood tests of cellular and humoral immunity related indexes were made before and on the 3rd, 7th, 14th, 21st day following the sonication. The histological changes of the target lesions were observed by light and electron microscope for the cases undergoing second stage operation. Results Light and electron microscope all revealed that HIFU could lead to irreversible changes in the tumor cells of the target lesions. There were not significant differences between the values of CD 3, CD 4, CD 8, CD 16, IgG, IgA, IgM,etc. before and after the ablation. Conclusions HIFU could destroy the tissues of HCC effectively. HIFU could not change the immunity of the patients with mid-advanced HCC remarkably. It may be ideal to unite immunotherapy and the other methods to get a sound clinical prognosis for HCC patients.