热化疗栓塞影响中晚期肝癌患者机体免疫功能的研究

目的观察经肝动脉热化疗栓塞对中晚期肝癌患者的机体免疫功能的影响。方法原发性肝癌患者40例完全随机分为2组，均采用经股动脉途径插管至肝动脉，A组（20例）ADM40mg＋MMC 10mg溶于37℃的生理盐水灌注；B组（20例）ADM40mg＋MMC 10mg溶于60℃的生理盐水灌注；A或B组灌注后再用适量碘化油栓塞。采用流式细胞仪及双抗体夹心法，检测治疗前、后外周血T细胞亚群（CD3^＋、CD4^＋、CD8^＋）、NK细胞的百分率及sIL-2R的变化。采用LDH释放法检测NK细胞的杀伤活性。结果与术前及普通化疗栓塞组比较，热化疗栓塞治疗后CD4^＋、NK细胞的百分率明显升高（P〈0．05），NK细胞杀伤活性也升高（P〈0．05），而CD8^＋细胞的百分率及sIL-2R的水平明显降低（P〈0．05）。结论热化疗栓塞具有免疫激活作用，可使机体的免疫功能得到一定程度的改善。

Study of changes in the immune function of patients with advanced Hepatic carcinoma after intra-arterial thermochemoembolization

Objective To study the changes in the immune function of advanced hepatic carcinoma patients after thermochemoembo-lization via hepatic artery. Methods Forty advanced hepatic carcinoma patients were randomized divided into 2 groups. A group (n=20) was treated by perfusion with ADM(40mg) + MMC(10mg) in 37℃ 9% sodium chloride solution via hepatic artery, and B group (n=20) was treated by perfusion with ADM(40mg) + MMC(10mg) in 60℃ 9% sodium chloride solution via hepatic artery, then all were embolized with some quantity of lipiodol. Flow cytometry (FCM) was used to detect the changes in percentages of T-lymphocyte subsets (CD3<'3, CD4<'+, CD8<'+) and NK cells, and the contents of soluble interleukin-2 receptor (sIL-2R) were detected by double sandwich ELISA before and after therapy. LDH enzyme-release assay was used to detect cytotoxic activity of NK cells. Results Compared with pre-therapy group or A group after therapy, the percentage of CD4<'+ cells of B group after therapy significantly increased (P<0.05), the percentages of CD8<'+ cells and the content of sIL-2R of B group after therapy markedly decreased (P<0.05). The percentages of NK cells and cytotoxic activity NK cells of B group after therapy were significantly higher than those from pre-therapy group or A group (P<0.05). Conclusion Intra-arterial thermochemoembolization may activate and improve cell-mediated immune function with a certain degree.