沙利度胺对原发性肝癌介入治疗后机体免疫功能的影响

目的探讨沙利度胺（TLD）联合肝动脉栓塞化疗（TACE）对原发性肝癌（HCC）患者细胞免疫功能的影响。方法30例被确诊为HCC，随机分为治疗组（A）、治疗组（B），A组（n=15）行TLD＋TACE治疗；B组（n=15）单用TACE治疗。TLD用法：200mg口服，每晚1次，连续用药2个月。TACE所用药物：奥沙利铂（L-OHP）200mg、氟脲脱氧核苷（FUDR）1．0g、碘化油5-40mL。治疗前和治疗后1个月用流式细胞仪检测患者外周血CD3^＋、C1M^＋、CD8^＋、CD4^＋／CD8^＋、CD3^-CD56^＋NK并与正常人对照组30例作比较。结果治疗前A、B两组与正常人比较CD3^＋、CD4^＋均正常（P〉0．05），但CD4^＋／CD8^＋、CD3-CD56^＋NK均明显偏低（P〈0．01）。治疗后A组T细胞亚群及NK细胞均恢复正常（P〉0．05）；B组与正常对照组比较CD3^＋、CD4^＋仍正常（P〉0．05）、但CD4^＋／CD8^＋、CD3^-CD56^＋仍显著偏低（P〈0．01）。结论TLD可改善HCC患者的细胞免疫功能。

The Changes of Cellular Immunity Function After Treatment of Thalidomide Combined with TACE for HCC

Objective To study the effect of thalidomide(TLD) in combination with transcatheter arterial chemoembolization(TACE) on cellular immunity function in patients with hepatocellular carcinoma(HCC).Methods 30 cases with HCC were randomly divided into two groups.A group(n=15) was treated by TLD combined with TACE.B group(n=15) was treated by TACE.The number of T cell subsets(CD3 ,CD4 ,CD8 ,and CD4 /CD8 ) and NK before and one month after TACE treatment was determined using flow cytometry and compared with the testing results of the thirty normal donators as the control group.Results The number of NK and ration of CD4 / CD8 of all HCC cases were lower before the therapy than those of the normal human beings(P<0.01),and it was not significantly different between A and B groups before treatment(P>0.05).The number of NK and ration of CD4 / CD8 of A group were enhanced after the therapy,and it was not significantly different than those of the normal human beings(P>0.05).But the number of NK and ration of CD4 / CD8 of B group were still lower after the therapy than those of the normal human beings(P<0.01).Conclusions The cellular immunity function of the patients with HCC was lower than that of the normal human beings.TACE might inhibit the cellular immunity function.Thalidomide might help enhance the cellular immunity function of the patients with HCC.