Changes Of Immune Function In Papillary Thyroid Microcarcinoma After Microwave Ablation

Objectives:To observe the effect of microwave ablation(MWA)on immune function of patients with papillary thyroid microcarcinoma(PTMC).Research the changes of T lymphocyte subsets(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+)and Th1 cytokines(IL-2,IFN-γ,TNF-α),Th2 cytokines(IL-4、IL-6、IL-10),Th17 cytokine(IL-17A)after microwave ablation.Materials and methods:Fifty patients who were diagnosed with papillary thyroid microcarcinoma and treated with ultrasound-guided microwave ablation in our hospital from December 2019 to October 2020 were selected as the research objects.Evaluate the effectiveness of microwave ablation in the treatment of PTMC through postoperative contrast-enhanced ultrasound and follow-up changes in the ablation zone volume.To evaluate the safety of microwave ablation in the treatment of PTMC by observing the occurrence of intraoperative and postoperative complications.The expression of T lymphocytes in peripheral blood of patients with papillary thyroid microcarcinoma was detected by flow cytometry before operation,1 day after operation,2 weeks after operation and 1 month after operation,including:CD3~+,CD4~+,CD8~+,CD4~+/CD8~+.The expression of Th1 cytokines(IL-2,IFN-γ,TNF-α),Th2 cytokines(IL-4,IL-6,IL-10)and Th17(IL-17A)in the peripheral blood of patients with papillary thyroid microcarcinoma before and after microwave ablation were detected by flow fluorimetry before operation,1 day after operation,2 weeks after operation and 1 month after operation.Results:1.Evaluation of the effectiveness of MWA in the treatment of PTMC by contrast-enhanced ultrasound and volume changes Contrast-enhanced ultrasound: one day after MWA treatment,the area of contrast-enhanced ultrasound completely covers and exceeds the scope of the lesion,achieving complete inactivation of the tumor lesion.Volume changes: compared with preoperatively,the volume of the ablation zone increased significantly one day after MWA treatment,and the difference was statistically significant(P < 0.05).Compared with 1day after operation,the volume of ablation zone decreased gradually at 2weeks and 1 month after MWA treatment,and the difference was statistically significant(P<0.05).2.Evaluation of the safety of MWA treatment of PTMC by observing complications.During and after MWA treatment,1 patient had transient hoarseness during the operation,and 2 patients had pain in the area behind the radioactive ear after the operation,and no serious complications were seen.3.Changes of immune function before and after MWA treatment of PTMC T lymphocyte subsets:The proportions of CD3~+,CD4~+,CD4~+/CD8~+ in peripheral blood of patients after MWA treatment were significantly higher at one day and 2weeks after treatment,and the differences were statistically significant(P<0.05).There was no statistically difference in the level of CD8~+ T cell compared with that before treatment(P>0.05).One month after MWA treatment,the proportions of CD3~+,CD4~+,CD8~+,CD4~+/CD8~+ in the peripheral blood of patients were similar to those before treatment,and the differences were not statistically significant(P>0.05).Cytokines secreted by Th1,Th2,Th17 cells:At 1 day and 2 weeks after treatment,the cytokines IL-2 and IFN-γsecreted by Th1 cell in peripheral blood of patients were significantly higher than those before treatment,and the differences were statistically significant(P < 0.05).The cytokine of TNF-α was not statistically different from that before operation(P>0.05);The cytokines IL-4,IL-10 and IL-6 secreted by Th2 cell were not different from those before microwave ablation(P>0.05).The IL-17 A cytokine secreted by Th17 cell was not statistically different from before operation(P>0.05).One month after MWA treatment,IL-2,IL-4,IL-6,IL-10,IFN-γ,TNF-α,IL-17 A cytokines were not significantly different from those before microwave ablation(P>0.05).Conclusions:1.Microwave ablation is safe and effective in the treatment of papillary thyroid microcarcinoma.2.One day and two weeks after microwave ablation with papillary thyroid microcarcinoma,T lymphocyte subsets and cytokines secreted by Th1 cell in peripheral blood of patients increased,suggesting that MWA can enhance the body’s immune function in a short period of time after surgery.