Sequential pathological and immunologic analysis of percutaneous microwave coagulation therapy of hepatocellular carcinoma
Sequential pathological and immunologic analysis of percutaneous microwave coagulation therapy of hepatocellular carcinoma
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DOI：
10.1080/0265673021000017154
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发表时间：
2003-01-01
影响因子：
3.1
通讯作者：
Yu, G
中科院分区：
文献类型：
--
作者：
Dong, BW;Zhang, J;Yu, G
目的：目的：探讨经皮微波凝固治疗（PMCT）后肝细胞癌（HCC）的病理和免疫学变化及其预后意义。89个结节被分为两组：治疗组，82名患者中有82个原发性结节（平均尺寸为3.4 +/- 1.2 cm），对照组，7名患者中有7个结节（平均尺寸为1.4 +/- 0.6 cm）。对照组中结节的入选标准是结节是同一患者的两个结节之一，并且两个结节位于不同的肝叶。这就保证了当一个结节被PMCT治疗时，远处的结节不会直接受到微波热场的影响。对照组在研究完成后进行结节治疗。在PMCT前后，在超声引导下从治疗结节和对照结节中采集标本。使用一组抗CD 3、CD 45 RO、CD 20、CD 56和CD 68的单克隆抗体，以免疫化学方法观察肿瘤组织中T淋巴细胞、B淋巴细胞、NK细胞和巨噬细胞的浸润。免疫细胞浸润的程度进行了比较之前和之后PMCT，以及治疗和对照结节之间。结果：随访2 ~ 26个月，平均14.6 ± 6.3个月。治疗组1年和2年肝内复发率分别为20.4%和28.1%。治疗组1年和2年生存率分别为92.5%和75.3%。T细胞，NK细胞和巨噬细胞在PMCT后治疗和未治疗的结节中均显著增加，尽管与治疗的结节相比，未治疗的结节中不太明显。有一个统计学显着的相关性之间的生存结果和免疫细胞infiltration.Conclusions的程度：对于不能手术的HCC患者，PMCT是一个治疗的选择是有效的。除了其组织凝固作用外，针对肿瘤的全身免疫反应增加也可能在提高生存率方面发挥重要作用。
Purpose: To evaluate sequential pathologic and immunologic changes and their prognostic significance after percutaneous microwave coagulation therapy (PMCT) of hepatocellular carcinoma (HCC).Methods: Eighty-nine nodules in 82 consecutive patients were studied. The 89 nodules were divided into two groups: a treatment group, with 82 primary nodules (average dimension was 3.4 +/- 1.2 cm) in 82 patients, and a control group, of seven nodules (average dimension was 1.4 +/- 0.6 cm) in seven patients. The criteria for a nodule s inclusion in the control group was that the nodule was one of two nodules in the same patient and that the two nodules were located in different liver lobes. This guarantees that while one nodule is treated by PMCT, the distant one will not be directly affected by the microwave thermal field. The control group nodules were treated after the study was completed. Specimens were taken with ultrasound-guided liver biopsy from the treated nodule and the control nodule, pre- and post-PMCT. Infiltration by T-lymphocytes, B-lymphocytes, NK cells and macrophages in the tumour tissue were observed immunohistochemically using a panel of monoclonal antibodies against CD3, CD45RO, CD20, CD56 and CD68. The extent of immune cell infiltration was compared both before and after PMCT, as well as between the treated and control nodules. The relationship between the prognosis and the extent of immunocyte infiltration was analysed.Results: The patients were followed for 2 26 months (mean 14.6 +/- 6.3) post-treatment. The recurrence rates at 1 and 2 years were 20.4% and 28.1% within the liver in treatment group, respectively. The survival rates at 1 and 2 years were 92.5% and 75.3% for the treatment group. T-cells, NK cells and macrophages increased significantly in both treated and untreated nodules after PMCT, albeit less markedly within untreated nodules when compared to the treated ones. There is a statistically significant correlation between survival outcome and the extent of immunocyte infiltration.Conclusions: For inoperable HCC patients, PMCT is one of the treatment choices shown to be effective. Apart from its tissue coagulation effect, an increased systemic immune response directed against the tumour may also play an important role in improved survival.