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目的研究射频消融治疗对原发性肝癌(HCC)患者外周血中Th1、Th2细胞因子的影响。方法采集30例HCC患者射频消融前和射频消融后3或7 d和肝癌复发时的血浆,用液相芯片检测Th1、Th2细胞因子水平的变化。结果射频消融后Th1型细胞因子干扰素-γ(IFN-γ)和白细胞介素-12p40(IL-12p40)水平较消融前明显增加[IFN-γ:(101.30±78.70)pg/ml vs.(55.70±36.20)pg/ml;IL-12p40:(57.70±31.90)pg/ml vs.(18.10±16.70)pg/ml;P均<0.05)。但肝癌复发后IFN-γ和IL-12p40水平比消融后的水平明显下降[IFN-γ:(56.50±41.70)pg/ml vs.(101.30±78.70)pg/ml;IL-12p40:(18.90±16.460)pg/ml vs.(57.70±31.90)pg/ml;P均<0.05),与消融前比较无明显差异。射频消融治疗前后,Th2型细胞因子IL-4和IL-6水平未出现明显变化[IL-4:(11.33±12.70)pg/ml vs.(13.31±15.56)pg/ml;IL-6:(17.86±22.93)pg/ml vs.(24.46±28.46)pg/ml]。射频消融治疗后,Th2型细胞因子水平下降者伴随较长的复发时间间隔[(14.00±4.35)月],而Th2细胞因子水平增高的患者复发时间则相对较短[(5.06±4.26)月]。结论射频消融可短期激活Th1型免疫反应,但激活的Th1型免疫反应不能预防肝癌的复发。Th2型细胞因子水平改变与肝癌复发时间有关,监测Th2型细胞因子水平变化可能有助于预测肝癌复发。
Objective To study the effect of radiofrequency ablation on Th1 and Th2 cytokines in peripheral blood of patients with primary hepatocellular carcinoma (HCC). Methods The plasma of 30 patients with HCC before radiofrequency ablation and 3 or 7 days after radiofrequency ablation and liver cancer recurrence were collected. The level of Th1 and Th2 cytokines was detected by liquid-phase chip. Results The levels of Th1 cytokines interferon-γ (IFN-γ) and interleukin-12p40 (IL-12p40) were significantly increased after radiofrequency ablation compared with before ablation [IFN-γ: (101.30±78.70) pg/ml vs. 55.70±36.20) pg/ml; IL-12p40: (57.70±31.90) pg/ml vs. (18.10±16.70) pg/ml; P all <0.05). However, the level of IFN-γ and IL-12p40 after liver cancer recurrence was significantly lower than that after ablation [IFN-γ: (56.50±41.70) pg/ml vs. (101.30±78.70) pg/ml; IL-12p40: (18.90± 16.460) pg/ml vs. (57.70±31.90) pg/ml; P all <0.05), and there was no significant difference compared with before ablation. Before and after radiofrequency ablation, the levels of Th2 cytokines IL-4 and IL-6 did not change significantly [IL-4: (11.33±12.70) pg/ml vs. (13.31±15.56) pg/ml; IL-6: 17.86±22.93) pg/ml vs. (24.46±28.46) pg/ml]. After radiofrequency ablation therapy, decreased Th2-type cytokines were accompanied by a longer recurrence interval [(14.00±4.35) months], while patients with elevated Th2 cytokine levels had a relatively short relapse time [(5.06±4.26) months] . Conclusions Radiofrequency ablation can activate Th1-type immune response in short-term, but activated Th1-type immune response can not prevent the recurrence of liver cancer. Changes in Th2 cytokine levels are associated with the time of recurrence of HCC. Monitoring changes in Th2 cytokine levels may help predict liver cancer recurrence.