TAE＋^32P与TAE治疗原发性肝癌患者sIL-2R、T淋巴细胞亚群改变的比较

目的 观测原发性肝癌患经肝动脉化疗栓塞（TAE） ^12P内照射治疗以及单纯TAE治疗后患可溶性白细胞介素2受体（sIL-2R）、T淋巴细胞亚群免疫功能状态的改变并进行比较。方法 采用双抗体夹心法和APAAP法测定患血清aIL-2R、T淋巴细胞亚群。结果 我们检测23例TAE ^32P、31例单纯TAE治疗原发性肝癌患和20例健康献血员aIL-2R、辅助T淋巴细胞、抑制T淋巴细胞。发现原发性肝癌患Th细胞比健康对照组显下降，（p<0.05），TAE ^32P治疗后恢复至正常水平。原发性肝癌患aIL-2R、Ta细胞比健康对照组明显增高，（p<0.05），TAE ^32P、TAE治疗后原发性肝癌患aIL-2R、Ta细胞非常显降低（p<0.05），TAE ^32比TAE下降更显，（p<0.05）。结论 TAE ^32P治疗原发性肝癌比单纯TAE治疗患血液中aIL-2R下降更显，两种治疗方法可使患Th增高、Ta下降。测定原发性肝癌患血液中aIL-2R，T淋巴细胞亚群对判断患免疫功能状态、疗效、预后有一定的价值。     

手足口病患儿外周血T淋巴细胞亚群的临床研究

目的 研究于足口病患儿T淋巴细胞亚群的变化趋势,为临床治疗及预后评估提供依据.方法 采用流式细胞仪检测2008年5月1日至8月31日在北京地坛医院住院的346例手足口病患儿急性期的T淋巴细胞亚群,同时测定其中67例患儿恢复期的T淋巴细胞哑群;对其中99例患儿咽拭子标本进行RT-PCR以确定病原.埘不同样本行独立样本t检验、配对t检验或方差分析.结果 手足口病患儿T淋巴细胞业群均数低于相应年龄段正常参考值水平.重症患儿各年龄组中的T淋巴细胞(TL)/淋巴细胞(L)比值、＞1岁组T辅助细胞(Th)/L比值,以及1～2岁患儿的TL、Th及Th/抑制性T淋巴细胞(Ts)值低于普通病例(P＜0.05).患儿T淋巴细胞亚群随病程进展有逐渐上升趋势,普通患儿的TL/L及Th/L在恢复期增高(TL/L:56.3±8.6比61.1±9.1,t=2.56,P＜0.05;Th/L:30.2±7.2比34.9±7.9,t=2.90,P＜0.05),重症患儿除Ts/L和Th/Ts外,所有指标均在恢复期明显增高(P＜0.01);急性期重症与普通崽儿的TL为(1.738±0.976)×10~6/L比(2.696±1.946)×10~6/L(t=2.17,P＜0.05),Th/L为25.9±7.0比30.2±7.2(t=2.34,P＜0.05),Th为(0.864±0.550)×10~6/L比(1.459±0.879)×10~6/L(t=2.90,P＜0.01),L为(3.352±1.458)×10~6/L比(4.664±2.435)×10~6/L(t=2.32,P＜0.05),恢复期两组比较差异无统计学意义(P＞0.05).肠道病毒(EV)71阳性患儿T淋巴细胞亚群各值均低于阴性患儿,但差异无统计学意义(P＞0.05).结论 T淋巴细胞免疫功能可能与手足口病发病及病情发展有关.     

小剂量茶碱调节哮喘患者T淋巴细胞的活性

目的 :观察茶碱对哮喘患者血清T淋巴细胞活性影响。方法 :检测哮喘患者每d给予茶碱控释片 4 0 0mg治疗 6周前后血清可溶性白细胞介素 2受体 (sIL 2R)浓度、T淋巴细胞亚群和IgE水平变化。结果 :哮喘患者经茶碱治疗 6周后其血清sIL 2R浓度显著下降 ,从治疗前 ( 0 31± 0 10 )U/L ,降低到治疗后 ( 0 2 5± 0 0 6 )U/L ,P <0 0 5。茶碱能显著提高哮喘患者外周血中的CD8T淋巴细胞数 (从治疗前的 18 9%± 4 4 %提高到治疗后的 2 5 8%± 5 9% ,P <0 0 5 ) ,同时CD4 /CD8%相应地显著降低 (P <0 0 5 )。茶碱并有降低哮喘患者外周血中IgE水平的趋势。结论 :小剂量茶碱能抑制哮喘患者血清T淋巴细胞活性 ,不仅具有抗炎作用 ,还有免疫调节作用 ,为评价茶碱在哮喘治疗中的作用提供了依据。     

DAB诱发大鼠肝癌过程中IL-2、T淋巴细胞亚群动态变化

目的:了解诱癌过程中大鼠免疫功能变化,观察大鼠IL-2、T淋巴细胞亚群动态变化及其相互关系。方法:应用二甲基奶油黄(DAB)诱发大鼠肝癌,在诱发大鼠肝癌的3个阶段分别取大鼠脾脏和外周血测定IL-2活性和T淋巴细胞亚群。结果:肝炎、肝硬变、肝癌期大鼠IL-2活性、Th降低有显著性,P<0.05或<0.01。肝癌期大鼠Ts显著增加,P<0.05。肝炎、肝硬变期IL-2活性与Th正相关,肝癌期大鼠IL-2活性与Ts负相关,与Th/Ts比值呈正相关。结论:诱发大鼠肝癌过程中,IL-2活性逐步降低,良性肝病期IL-2活性与Th下降有关,肝癌期IL-2活性与Ts增加和Th/Ts比值降低有关。肝炎期IL-2活性显著下降提示有早期肝癌发生的可能。     

甲型肝炎患者外周血T淋巴细胞亚群变化与SIL—2R水平关系的研究

应用间接免疫荧光技术和双抗体夹心ELISA法对50例甲型肝炎(以下简称甲肝)患者外周血T淋巴细胞亚群、可溶性白细胞介素—2受体(SIL—2R)水平进行动态观察。结果显示:急性期患者的CD_4~ 细胞百分比明显低于正常对照组(P<0.01),CD_8~ 细胞百分比与正常对照组比则有所上升(P<0.05),CD_4~ /CD_8~ 值低于正常对照组(1.08±0.28比1.45±0.15),SIL—2R水平与正常对照组比则明显升高(P<0.001),CD_4~ /CD_8~ 值与患者SIL—2R水平有负相关关系;恢复期患者的T淋巴细胞亚群变化可恢复到正常水平,SIL—2R水平也下降至接近正常。结果表明甲型肝炎患尤惠性期有一过性的淋巴细胞亚群改变及T淋巴细胞的活化,提示细胞免疫与甲型肝炎的发病权理有一定的关系。     

肝癌患者外周血T细胞亚群NK活性及IL-2R表达的研究

本文对30例原发性肝癌及30例正常对照进行外周血T细胞亚群、NK活性及IL—2R表达检测,结果表明肝癌患者外周血CD_8细胞增高,CD_4细胞降低,CD_4/CD_8比值上升,NK活性减低及IL—2R表达阳性率降低,提示肝癌患者机体免疫功能较正常人明显降低。     

50例肝癌患者外周血淋巴细胞亚群比例与肝功能损伤的关系

目的探讨肝癌患者外周血CD3~+T淋巴细胞、CD4~+T淋巴细胞、CD8~+T淋巴细胞、NK细胞亚群与肝功能损伤的关系。方法回顾性分析上海交通大学医学院附属仁济医院50例肝癌住院患者(原发性肝癌10例,继发性肝癌30例,合并其他肝脏疾病10例)外周血淋巴细胞亚群比例。以10例合并其他肝脏疾病患者作为疾病对照组,40名健康体检者作为健康对照组,结合患者的肝功能指标进行差异性和相关性分析。结果原发性肝癌患者淋巴细胞亚群比例与合并其他肝病组及健康对照组比较差异均无统计学意义。继发性肝癌患者CD4~+T淋巴细胞比例显著低于健康对照组[(29.18±2.11)%比(35.68±0.56)%,P0.05],NK细胞比例显著高于健康对照组[(21.45±1.69)%比(15.78±0.72)%,P0.01],其淋巴细胞亚群比例与合并其他肝病组比较差异均无统计学意义。原发性肝癌患者肝细胞损伤者CD4~+T淋巴细胞比例显著高于未损伤者[(45.90±5.96)%比(30.93±1.76)%,P0.05],CD4~+T淋巴细胞比例与ALT、AST均呈高度正相关(r=0.941、r=0.903,均P0.01),肝脏代谢功能受损者CD8~+T细胞比例显著低于正常者[(27.00±4.63)%比(34.01±7.98)%,P0.05],CD8~+T细胞比例与STB、PT均呈显著负相关(r=-0.596、r=-0.577,均P0.05)。继发性肝癌患者肝细胞损伤者CD4~+T细胞比例显著低于未损伤者[(23.22±3.28)%比(33.24±2.29)%,P0.05],CD8~+T细胞比例显著高于未损伤者[(34.70±4.26)%比(25.84±1.99)%,P0.05],CD4~+/CD8~+比值与ALT、AST均呈显著负相关(r=-0.470、r=-0.424,均P0.05),肝脏代谢功能受损者CD4~+T细胞比例显著高于正常者[(35.64±2.84)%比(25.56±2.57)%,P0.05],CD4~+/CD8~+比值与STB、PT均呈显著正相关(r=0.400、r=0.481,均P0.05)。结论肝癌患者外周血淋巴细胞亚群比例与肝功能损伤密切相关,机体免疫平衡状态的维持对于保护肝癌患者肝脏功能具有重要意义。     

沉默免疫负调控基因技术修饰的树突状细胞治疗原发性肝癌后T淋巴亚群分析

目的探究使用沉默免疫负调控基因(iAPA)细胞疗法对原发性肝癌术后患者T淋巴细胞亚群的变化。方法选取南京医科大学附属医院12例原发性肝癌手术切除后患者,男7例,女5例,年龄37~73岁。术前用血细胞分离机采集外周血单个核细胞悬液60 ml,贴壁分离培养树突状细胞(DC),iAPA因子(含抑制SOCS1的siRNA等)转染DC。第7天将成熟的DC回输至患者体内。患者治疗两个疗程后,采用流式细胞术检测治疗前后外周血T淋巴细胞亚群。结果患者一般情况普遍得到明显改善。外周血T淋巴细胞亚群检测结果表明:CD3~+T淋巴细胞高于治疗前,CD3~+CD4~+T+CD3~+CD8~+T淋巴细胞比例之和高于治疗前,差异均有统计学意义(P0.05)。结论 iAPA-DC疗法可以改善原发性肝癌免疫抑制状态,提高T淋巴细胞抗肿瘤效应,是有效的生物细胞技术之一。     

乳腺癌患者荷瘤状态T淋巴细胞亚群检测及其临床意义

目的检测乳腺癌患者外周血T淋巴细胞总数及T淋巴细胞亚群中的CD4+T细胞、CD8~+T细胞、CD45RA~+T细胞、CD45RO~+T细胞的百分率以评价患者的免疫状态。方法试验组选择女性原发性乳腺肿瘤患者40例,其中Ⅰ期乳腺癌23例,Ⅱ+Ⅲ期乳腺癌17例;以女性健康体检者30例为对照组。应用流式细胞仪,采用三色荧光免疫标记技术分别检测各组外周血T淋巴细胞亚群的数量,统计分析各组检测结果的差异性。结果试验组CD3~+T细胞、CD4~+T细胞百分率明显低于对照组(P0.05),Ⅱ+Ⅲ期患者明显低于Ⅰ期患者(P0.05)。与对照组比较,试验组CD45RA~+T细胞明显减少,而CD45RO~+T细胞明显增多(P0.05);与Ⅰ期乳腺癌患者比较,Ⅱ+Ⅲ期乳腺癌患者CD45RA~+T细胞明显减少,而CD45RO~+T细胞明显增多,差异有统计学意义(P0.05)。结论 T细胞亚群检测是评价肿瘤患者细胞免疫功能的重要指标,具有重要的临床应用价值。乳腺癌患者免疫功能与肿瘤恶变的发生、发展及临床分期有一定相关性,随着病情的进展,机体免疫功能呈现下降趋势。     

原发性肝癌患者术后外周血T淋巴细胞亚群及NK细胞水平与复发转移的相关性

目的 分析外周血T淋巴细胞亚群、同种异体自然杀伤细胞(NK)水平与原发性肝癌患者复发转移的关系.方法 回顾分析,选择2017年3月至2019年3月期间接受肝切除术治疗的58例原发性肝癌患者作为研究对象,根据患者术后随访复发情况将其分为复发转移组(21例)与未复发转移组(37例).采集各患者外周血,检测并比两组患者T淋巴...     

Gastric Mucosal Blood Flow Before and After TAE

Abstract: An evaluation of gastrointestinal complications after transcatheter arterial embolization (TAE) was conducted by endoscopy in order to investigate the pathogenesis of post TAE gastrointestinal complications. In addition, the gastric mucosal blood flow (GMBF) was evaluated by a laser doppler. The incidence of complications following the administration of a H₂–blocker was 34.1%, whereas the incidence following the administration of PGE1 and without medication were 2.3% (P >0.01) and 9.4%, respectively. In the group which did not receive medication, just after a TAE the GMBF decreased markedly in the lesser curvature of the gastric antrum (P >0.01), and in the lesser and greater curvature of the gastric body. This persisted from 1 to 7 days after the TAE with the GMBF showing a tendency to recover. On the other hand, in the group who received PGE1, the GMBF did not decrease in any site of the stomach following TAE. These findings suggested that the ischemia which occurred due to a decrease in the GMBF caused the gastrointestinal complications seen.     

The assessment of preoperative transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC)--the comparison between "whole-liver" TAE and "lobar or segmental" TAE]

In 180 patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy, 52 patients were received preoperative arterial chemoembolization (TAE) for the whole liver (whole-liver TAE group: group A), 39 for the limited area of the liver (lobar or segmental TAE group: group B) and the remaining 89 had no treatments before surgery (control group: group C). In order to evaluate the significance of preoperative TAE, long-term prognoses were compared among the three groups. Although there were no significant differences in survivals between A and C, the 2- and 6-year survivals in group B were significantly better than those in group C (P less than 0.05). With regard to reduction rates of tumors and necrotizing effect for daughter nodules after TAE, the lobar or segmental TAE was significantly superior to the whole-liver TAE. Moreover, the lobar or segmental TAE deteriorated the liver function significantly less than the whole-liver TAE. These findings suggest that the lobar or segmental TAE is more advantageous than the whole-liver TAE as a preoperative adjuvant therapy.     

A combination treatment of transcatheter arterial embolization (TAE) and irradiation for hepatocellular carcinoma (HCC)--evaluation for therapeutic efficacy in comparison with TAE or irradiation alone

Therapeutic effects of a combination therapy (TAE and irradiation) and a radiation therapy alone were evaluated comparatively in 54 patients with HCCs. Twenty eight patients of them underwent external X-irradiation with a linear accelerator after TAE and the remaining twenty six did irradiation alone. The incidence of partial response was 82.1% in the combination therapy and 69.2% in the radiation therapy. The cumulative rates of survival in the combination therapy were 70.8% (1-year), 37.1% (3-year), and 27.9% (5-year), which were higher than those in the radiation therapy. The cumulative rates of recurrence in the former were lower than those in the latter. The prognoses after the both treatments were poor in the patients with advanced liver cirrhosis (Child C). In the patients with HCCs smaller than 5 cm in diameter or accompanied by portal vein thrombi, the combination therapy was superior to TAE alone in the cumulative rates of survival. It is considered from the above results that the combination therapy is useful in the patients with HCCs when properly selected.     

Bone scintigraphy of skeletal metastasis in hepatoma patients treated by TAE

BACKGROUND/AIMS: Skeletal metastasis in hepatocellular carcinoma patients has become clinically important as a result of advances in treatment modalities. However, the diagnostic accuracy of bone scintigraphy in hepatocellular carcinoma has been questioned. METHODOLOGY: 99mTc-MDP bone scintigraphy was performed in 63 unresectable hepatocellular carcinoma patients treated by transcatheter arterial embolization who either developed musculoskeletal pain (n = 43) or elevated serum alpha-fetoprotein levels (n = 20) during follow-up. Results were categorized as positive or negative for metastases, and their accuracy was evaluated by radiological studies, biopsy, and clinical follow-up. RESULTS: Bone scintigraphy was positive in 22/43 (51.2%) subjects with pain and 2/20 with alpha-feto-protein elevation. Among 24 bone scintigraphy(+) patients, metastasis was confirmed in 17 and excluded in 6. Frequent sites for metastatic bone scintigraphy lesions were the spine, pelvic bone and ribs. Although 8 metastatic lesions had low or mixed uptake, most had increased uptake on bone scintigraphy. Among 39 bone scintigraphy(-) patients, metastasis was excluded in 32 and confirmed in 1. The sensitivity and specificity of bone scintigraphy in this subset of patients was 94.4% and 84.2%, respectively. CONCLUSIONS: Transcatheter arterial embolization treated hepatocellular carcinoma patients with musculoskeletal pain have a high likelihood of bone metastasis, and bone scintigraphy is a highly reliable method for its detection.     

Acute pancreatitis after transcatheter arterial embolization (TAE) for hepatocellular carcinoma

Transcatheter arterial embolization (TAE) has been widely used for treatment of hepatocellular carcinoma. Acute pancreatitis occasionally occurs as a complication of TAE. We have investigated the possible effects of TAE on the pancreas by monitoring serum pancreatic enzyme activities following TAE with various embolic materials. Serum amylase activity was increased very little in the patients treated with chemotherapy alone or plus TAE with lipiodol, slightly increased in many of the patients treated with chemotherapy plus TAE with gelatin sponge, and increased in all of the patients treated with chemotherapy plus TAE with gelfoam powder. The activity was increased to a level as high as 700 U/dl or more in most individuals of the last category. In one of them acute pancreatitis developed, probably because the gelfoam powder regurgitated into the pancreaticoduodenal artery, and occluded a very peripheral portion of the pancreatic vascular bed, leading to ischemia of the pancreas. These results suggest that choosing the correct particle size is important for prevention of acute pancreatitis.     

Risk factors for recurrence of large HCC in patients treated by combined TAE and PEI

BACKGROUND/AIMS: In this report, risk factors of intrahepatic recurrence of a large solitary hepatocellular carcinoma after combination therapy with transcatheter arterial embolization followed by percutaneous ethanol injection were studied. METHODOLOGY: The series included 61 patients with an unresectable large solitary hepatocellular carcinoma, the largest size of which was greater than 3 cm in diameter. All patients completely responded to combination therapy and recurrence rates were determined. The following parameters; age, sex, hepatitis B virus surface antigen, hepatitis C virus antibodies, Child's classification, alcohol abuse, alanine aminotransferase, aspartate aminotransferase, alpha-fetoprotein, indocyanine green retention rate, hepatocellular carcinoma size, hepatocellular carcinoma capsule, total amount of injected ethanol and the alpha-fetoprotein 1 month after treatment were evaluated. RESULTS: The 1-, 3-, and 5-year cancer-free survival rates of all patients were calculated to be 61%, 23%, and 13%, respectively. Among pretreatment parameters, the log-rank test and subsequent Cox's proportional hazards model showed that a tumor size of more than 5 cm in diameter was independently associated with recurrence. The posttreatment parameters of total amount of injected ethanol was also shown to be significantly related to recurrence by the log-rank test. CONCLUSIONS: Lesions more than 5 cm in diameter and insufficient injected ethanol were associated with intrahepatic recurrence after this combination therapy.     

Therapeutic effect of TAE can be predicted by abdominal-enhanced CT findings in HCC

BACKGROUND/AIMS: In order to improve the therapeutic efficacy of transcatheter arterial embolization (TAE) in hepatocellular carcinoma (HCC), the relationship between CT findings and antitumor efficacy was studied. METHODOLOGY: The therapeutic effect on CT 1 year after TAE was respectively studied for 100 nodules of HCC where TAE was performed. The pre-treatment abdominal CT findings were classified, and the therapeutic effect was compared with regard to these attributes. RESULTS: Tumors determined to have no recurrence at the treated site (defined as "complete necrosis") accounted for 58% overall. The percentage of "complete necrosis" in pre-TAE CT findings by type showed that 1) in terms of tumor shape, 73.4% were smooth type, 34.5% irregular type, and 0% invasive type (p = 0.0003), 2) in terms of the presence of corona nodules, nodules where "complete necrosis" was achieved were corona-positive in 67.7% and coronanegative in 37.1% (p = 0.003), 3) in terms of tumor size, 68.3% of tumors were smaller than 3.0cm and 28.6% were larger than 3.1cm, 4) in terms of location, 64.6% of tumors were in a peripheral location and 28.6% in a central location (p = 0.006). CONCLUSIONS: The therapeutic effect of TAE is improved by adequate diagnosis of the tumor characteristics found on pre-treatment CT.