原发性肝癌患者射频消融治疗前后外周血T细胞亚群及NK细胞的变化

目的观察原发性肝癌患者射频消融（RFA）治疗前后T细胞亚群及NK细胞的变化。方法23例原发性肝癌患者接受RFA治疗；采用流式细胞仪检测患者和23例健康体检人群外周血CD3＋T细胞、CD4＋T细胞、CD4＋/CD8＋、CTL细胞及NK细胞水平。结果原发性肝癌患者CD3＋T细胞、CD4＋T细胞、CTL细胞、NK细胞的比例及CD4＋/CD8＋比值分别为61.9±13.8%、33.3±5.0%、10.3±4.9%、4.4±1.3%和1.4±0.6，均显著低于健康人群（75.7±12.3%、41.1±10.1%、19.7±5.8%、16.7±8.2%、1.7±0.6，P〈0.05）；CD8＋T细胞的比例为25.5±5.1%，高于健康人（21.7±6.7%，P〈0.05）；RFA治疗后1周和2周，CD3＋T细胞（72.1±9.8%、73.3±7.3%）、CD4＋T细胞（39.6±10.9%、39.0±10.0%）、CTL细胞（14.8±9.6%、12.3±7.4%）、NK细胞（11.1±4.9%、12.8±8.1%）均较治疗前上升，而CD8＋T 细胞（22.6±5.8%、22.0±9.6%）比例下降，CD4＋/CD8＋比值（1.7±0.8、1.9±0.4）上升，差异均有统计学意义（P〈0.05）。结论原发性肝癌患者大多处于免疫抑制状态，RFA治疗可调节其T细胞亚群的平衡，升高NK细胞水平。

Changes in peripheral T-cell subsets and natural killer cell in patients underwent radiofrequency abla-tion for primary liver cancer

Objective To investigate the changes in peripheral T lymphocyte subsets and natural killer （NK）cells in patients underwent radiofrequency ablation（RFA）for primary liver cancer. Methods 23 patients with primary liver cancer were recruited and received RFA treatment. The changes in the proportion of CD3＋Tcell,CD4＋Tcell,CTL cell,NK cells,and CD4＋/CD8＋ ratio in peripheral blood in 23 healthy controls and in 23 patients with primary liver cancer before and after RFA treatment were determined by flow cytometry. Results The proportion of CD3＋Tcell,CD4＋Tcell,CTL cell,NK cell and the CD4＋/CD8＋ ratio in patients with primary liver cancer were 61.9±13.8%,33.3±5.0%,10.3±4.9%,4.4±1.3% and 1.4±0.6,respectively,all of which were significantly lower than those in healthy controls （75.7±12.3%,41.1±10.1%,19.7±5.8%,16.7±8.2%,1.7±0.6,P〈0.05）;In contrast,the proportion of CD8＋T cell （25.5±5.1%）in patients was higher than that in healthy controls （21.7±6.7%,P〈0.05）;In patients with primary liver cancer,the proportion of CD3＋T cell（72.1±9.8%,73.3±7.3%）,CD4＋T cell（39.6±10.9%,39.0±10.0%）, CTL cell（14.8±9.6%,12.3±7.4%）and NK cell（11.1±4.9%,12.8±8.1%）were increased,while the proportion of CD8＋T cell（22.6±5.8%,22.0±9.6%）was reduced,and the CD4＋/CD8＋ ratio（1.7±0.8,1.9±0.4）was decreased（P〈0.05）one or two weeks after RFA as compared to that before RFA. Conclusion Most of the patients with primary liver can-cer are in immunosuppressed status,and RFA therapy can adjust the balance in T cell subsets and increase NK cell counts.