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目的 探讨经皮局部微波热凝固治疗 (PMCT)肝癌与病灶局部细胞免疫的关系及其对预后的影响。方法 82例患者的 89个原发肝癌结节接受PMCT。其中 7例患者肝内有多发结节且其中 1个结节与第 1次治疗的主结节不在同一肝叶 ,与主结节远隔的较小癌结节在主结节治疗过程中作为对照组观察 ,观察 1 7d后再行PMCT。在超声引导下于患者PMCT前及后 1 7d时取治疗组和观察组结节组织 ,用免疫组织化学染色方法检测治疗前后癌组织内CD3+ 、CD45RO+ 、CD8+ 、CD68+ 、CD56+ 、CD2 0 + 细胞及T淋巴细胞Fas 配体。分析免疫细胞浸润程度与复发率的关系。结果 治疗组 1年和 2年肝内复发率分别为 2 0 4%和 2 8 1 %。PMCT前治疗结节和观察结节内均有少量CD3+ 、CD56+ 和CD68+ 细胞浸润。治疗结节T淋巴细胞Fas 配体阳性率为 8%。PMCT后 ,治疗结节和观察结节内免疫细胞浸润程度明显增加 ,细胞直径明显增大 ,但观察结节不如治疗结节免疫细胞变化明显。治疗组T淋巴细胞Fas 配体阳性率明显增加 ,免疫细胞浸润程度高者的 1年复发率明显低于浸润程度低者。结论 PMCT肝癌可增强病灶局部的细胞免疫功能。这种增强的细胞免疫有可能是针对被治疗肿瘤的
Objective To investigate the relationship between percutaneous microwave local thermal coagulation therapy (PMCT) and local cellular immunity and its effect on prognosis. Methods Eighty-nine patients with primary hepatocellular carcinoma nodules underwent PMCT. Seven of these patients had multiple nodules in the liver and one of the nodules was not in the same lobe as the primary nodule of the first treatment. Small nodules distant from the main nodule were treated as major nodules during treatment The control group observed, observed after 17d PMCT. Under the guidance of ultrasound, the nodules of the treatment group and the observation group were taken before and after the PMCT of the patients and the expressions of CD3 +, CD45RO +, CD8 +, CD68 +, CD56 +, CD20 + cells in the cancer tissue before and after treatment were detected by immunohistochemical staining T lymphocyte Fas ligand. The relationship between immune cell infiltration and recurrence rate was analyzed. Results The intrahepatic recurrence rates at 1 year and 2 years in the treatment group were 20.4% and 2 8 1%, respectively. A small amount of CD3 +, CD56 + and CD68 + cells infiltrated in both PMCT and nodules. The positive rate of Fas ligand of T lymphocytes in treatment nodules was 8%. PMCT, the treatment of nodules and observed nodules within the immune cell infiltration increased significantly, cell diameter increased significantly, but the observed nodules than the treatment of nodular immune cells significantly. The positive rate of Fas ligand in T lymphocyte in treatment group increased significantly, and the one-year recurrence rate of T lymphocyte in treatment group was significantly lower than that in infiltration degree. Conclusion PMCT hepatocarcinoma can enhance the local cellular immune function. This enhanced cellular immunity is likely to target the treated tumor