TACE联合肿瘤间质对介入治疗肝细胞癌患者免疫功能的影响

发布时间：2018-01-28 19:35

本文关键词： 单纯经肝动脉化疗栓塞联合肿瘤间质肝细胞癌免疫功能可溶性白细胞介素-受体　出处：《中国老年学杂志》2017年24期 　论文类型：期刊论文

【摘要】：目的探讨单纯经肝动脉化疗栓塞(TACE)联合肿瘤间质对介入治疗肝细胞癌(HCC)患者免疫功能的影响。方法 90例HCC患者随机分为对照组和实验组,对照组行TCAE治疗,实验组行TCAE联合经皮肝瘤内注射碘油化疗药物进行肿瘤间质治疗,另选取体检健康者为空白组45例。分别采用流式细胞技术及酶联免疫吸附(ELISA)法测定患者治疗前、治疗后1、2、3、4 w外周血T淋巴细胞亚群(CD3~+、CD4~+、CD8~+)和血清可溶性白细胞介素-2受体(SIL-2R)水平。结果治疗前实验组和对照组T淋巴细胞亚群和SIL-2R水平与空白组比较差异显著(P0.05);治疗1、2、3、4 w后CD3~+、CD4~+及CD4~+/CD8~+比值明显升高,CD8~+和SIL-2R水平明显下降(P0.05)。治疗1、2、3 w后,对照组与实验组CD8~+和CD4~+/CD8~+比值无统计学差异(P0.05),治疗4 w后CD4~+/CD8~+有统计学差异(P0.05),治疗1、2、3、4 w后,对照组和实验组CD3~+、CD4~+和SIL-2R水平均有统计学差异(P0.05)。实验组不良反应较对照组轻。结论 TACE联合肿瘤间质能够明显提高患者的免疫能力,改善患者的免疫抑制,且能够弥补单纯使用TACE治疗的不足。
[Abstract]:Objective to investigate the effect of transcatheter arterial chemoembolization (TACEE) combined with interventional therapy for hepatocellular carcinoma (HCC). Methods 90 patients with HCC were randomly divided into control group and experimental group. The control group was treated with TCAE, the experimental group was treated with TCAE combined with percutaneous intrahepatic injection of lipiodol chemotherapeutic drugs for interstitial tumor therapy. In addition, 45 healthy persons were selected as blank group. Flow cytometry (FCM) and Elisa were used to determine the level of 2x3 before and after treatment. 4. Peripheral blood T lymphocyte subsets CD3 ~ + CD4 ~. CD8 ~) and serum soluble interleukin-2 receptor sil 2R). Results before treatment, the levels of T lymphocyte subsets and SIL-2R in the experimental group and control group were significantly different from those in the blank group (P 0.05). The ratio of CD3 ~ + CD4 ~ and CD4 ~ / / CD8 ~ were significantly increased after 4 weeks of treatment. The levels of CD8 ~ and SIL-2R decreased significantly (P 0.05). There was no significant difference in the ratio of CD8 ~ and CD4 ~ / CD8 ~ ~ between the control group and the experimental group (P 0.05). After 4 weeks of treatment, there was a significant difference in CD4 ~ / / CD8 ~. After 4 weeks of treatment, the control group and the experimental group were treated with CD3 ~. There were significant differences in CD4 ~ and SIL-2R levels between the two groups (P 0.05). The adverse reactions in the experimental group were lighter than those in the control group. Conclusion TACE combined with tumor stroma can significantly improve the immune ability of the patients. Improve the immunosuppression of patients, and can make up for the lack of TACE alone.
【作者单位】：新疆医科大学第五附属医院血管肿瘤介入科;新疆医科大学第五附属医院胃肠外科;
【分类号】：R735.7
【正文快照】： 1新疆医科大学第五附属医院胃肠外科肝的微环境存在各种细胞因子和趋化因子,是影响肝细胞癌(HCC)进展和转移的关键因素[1,2]。肿瘤免疫主要与T淋巴细胞的免疫有关,T淋巴细胞亚群(CD3+、CD4+、CD8+)是反映机体细胞免疫功能的一个指标[3],特别是CD4+/CD8+比值是反映细胞免疫平衡

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