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目的探究肝癌患者应用微创介入治疗对患者T细胞免疫功能的影响。方法回顾性分析2014年1月-2014年12月我院收治的122例肝癌患者的临床资料,根据所采用治疗方式的不同将其分为射频消融(RFA)组和手术组,各61例。对术后两组患者相关免疫指标表达情况进行比较分析。结果治疗2周后,RFA组CD3+、CD4+以及CD4+/CD8+和NK细胞数目均比治疗前明显升高(P<0.05);治疗4周后,这些指标依然呈现升高趋势(P<0.05);手术组在治疗2周后CD3+、CD4+以及CD4+/CD8+和NK细胞数与治疗前相比没有明显差别(P>0.05),而治疗4周后上诉指标较治疗前明显升高(P<0.05),但均较同期RFA组低(P<0.05)。RFA组CD8+细胞数目与治疗后均较治疗前明显降低,但治疗4周后降低的更加明显,而手术组CD8+细胞数目确在治疗4周后开始明显降低,并且RFA组较同期手术组下降的更明显(P<0.05)。RFA组在经过2周的治疗后,除RBC-ICR比医治前明显下降外,RBC-C3bRR、RBC-TRR均明显升高(P<0.05);手术组医治4周后上述指标才开始明显改善(P<0.05),但都较同期RFA组改善的差(P<0.05)。RFA组在经过2周的治疗后血清中TNF-α、IL-2及IFN-γ的浓度均比医治前明显升高(P<0.05),医治4周后这些指标依然升高(P<0.05);手术组在医治4周后血清中TNF-α、IL-2及IFN-γ的浓度与医治前比较才有明显升高(P<0.05),但均较同期RFA组低(P<0.05)。结论同手术方法相比,肝癌患者采用RFA医治,可以明显改善其淋巴细胞及其细胞免疫功能,对Th1型细胞的分泌具有促进作用,有利于肝癌患者的治疗。
Objective To investigate the effect of minimally invasive interventional therapy on T cell immune function in patients with liver cancer. Methods The clinical data of 122 patients with HCC who were treated in our hospital from January 2014 to December 2014 were retrospectively analyzed. According to the different treatment methods, they were divided into radiofrequency ablation (RFA) group and operation group, 61 cases each. The postoperative two groups of patients with immune indicators were analyzed comparatively. Results After treatment for 2 weeks, the number of CD3 +, CD4 + and CD4 + / CD8 + and NK cells in RFA group was significantly higher than that before treatment (P <0.05). After 4 weeks of treatment, the indexes were still increasing (P <0.05) There was no significant difference in the number of CD3 +, CD4 +, CD4 + / CD8 + and NK cells in the operation group after 2 weeks of treatment (P> 0.05), but the index of appetite in the operation group after 4 weeks of treatment was significantly higher than that before treatment (P <0.05) , But lower than the same period RFA group (P <0.05). The number of CD8 + cells in the RFA group was significantly lower than that before treatment, but the number of CD8 + cells in the operation group decreased significantly after 4 weeks of treatment, but decreased significantly in the RFA group compared with the surgery group More obvious (P <0.05). After 2 weeks of treatment, the RBC-C3bRR and RBC-TRR were significantly increased in the RFA group (P <0.05) except RBC-ICR decreased significantly after treatment; (P <0.05), but both of them were worse than that of RFA group at the same period (P <0.05). The levels of TNF-α, IL-2 and IFN-γ in serum of RFA group after 2 weeks treatment were significantly higher than those before treatment (P <0.05), and were still increased after 4 weeks of treatment (P <0.05 ). The serum levels of TNF-α, IL-2 and IFN-γ in the operation group after 4 weeks of treatment were significantly higher than those before treatment (P <0.05), but lower than those in the RFA group ). Conclusion Compared with the surgical method, the treatment of liver cancer patients with RFA can significantly improve the lymphocyte and its cellular immune function, the secretion of Th1-type cells have a promoting effect, is conducive to the treatment of patients with liver cancer.