Pilot Study Of Immune Function Change After Ultrasound-Guided Percutaneous Ethanol Injection For Hepatocellular Carcinoma

Objective:To analyze the effect of ultrasound-guided percutaneous ethanol injection(PEI)on immune function of patients with hepatocellular carcinoma(HCC)by monitoring the change of immune indexes in peripheral blood before and after the therapy of PEI.Methods:From November.2006 to August.2007,30 patients with HCC that cured by PEI enrolled experimental group.These patients' peripheral venous blood were adopted to evaluate the level ofT cell subsets(CD₃⁺,CD₄⁺,CD₄⁺,CD₈⁺,),NK cells,IL-6,TGF-β1.In addition,the Echo and flow imaging changes of the tumor cured by PEI and liver tissue around were observed and recorded by color Doppler ultrasound before each anhydrous ethanol injection. On the other hand,20 persons who did outpatient medical examination were selected as control group without tumor and liver disease,then peripheral venous blood of these persons were adopted to detect above indexes.All indexes of the experimental group compared with control group by independent samples T-test,and the indexes before and after PEI treatment were compared with repeated measure analysis of variance.Results:The CD₃⁺,CD₄⁺,CD₄⁺/CD₈⁺,NK levels of experimental group before PEI were lower than those of control group,and the differences had statistical significances(P_CD3+＜0.01,P_CD4+＜0.01,P_CD4+/CD8+＜0.01,P_NK＜0.01). and the CD₈⁺,IL-6,TGF-β1 levels of experimental group before PEI were statistically higher than those of control group(P_CD8+＜0.01,P_IL-6＜0.01,P _TGF-β1＜0.01).After the 3rd treatment of PEI,the CD₃⁺,CD₄⁺,CD₄⁺/CD₈⁺,NK had no significant difference from that before PEI respectively(P_CD3+＞0.05,P_CD4+＞0.05,P_CD4+/CD8+＞0.05,P_NK＞0.05).After 6th and 8th treatment,CD₃⁺,CD₄⁺,CD₄⁺/CD₈⁺,NK were significantly higher than that before PEI respectively(P_CD3+＜0.05,P_CD4+＜0.05,P_CD4+/CD8+＜0.05,P_NK＜0.05).While CD₈⁺ decreased significently until 8th treatment(P＜0.05).The levels of IL-6 and TGF-β1 after 3rd treatment were significently higher than that before PEI (P_IL-6＜0.05,P_TGF-β1＜0.05),and both rapidly reduced to pretherapy level after 6th treatment(P_IL-6＞0.05,P_TGF-β1＞0.05).After 8th treament,IL-6 reduced but had no significant difference from that before PEI(P＞0.05),but TGF-β1 reduced significantly and lower than that before PEI statistically(P＜0.05).After PEI therapy,the echo of each tumor nodule became strong,and there were 38(86.36%)tumor nodules that became high uniform Echo.After PEI treament,all of blood flow signals in 15 nodules disappeared(100%).Conclusions:PEI can effectively kill tumor cells,reduce the tumor burden, and increase immune function.But PEI may cause a transient immune suppression at the early therapy.