| Objective: To explore the effect on immune system after ultrasound-guidedradiofrequency ablation, and to summarize the ultrasonographic features ofradiofrequency ablation.Methods: According to the inclusion criteria, there were93cases with completeclinical data and clinically diagnosed as the primary liver cancer (32cases) and thesecondary liver cancer (61cases). Collected those93patients of peripheral venousblood samples to assay the level of CD3+, CD4+, CD8+, CD4+/CD8+, NK cells beforeRFA，2weeks，and1month after RFA treatment by flow cytometry（FCM）, and tookstatistical analysis. At the same time we took the ultrasound examination for thosepatients to observe and summarize the features of radiofrequency ablation.Results:1. Changes in peripheral blood lymphocyte subsets before and after RFAtreatment：①CD3+：CD3+cells numbers pre-operation were compared with2weekspost-operation,1month before with after operation,2weeks post-operation with1month post-operation, there was no significant difference between each group （P＞0.05）.②CD4+、CD4+/CD8+： The cells numbers of2weeks and1monthpost-operation were respectively compared with pre-operation. It increased significantly（P＜0.01）. The cells numbers of2weeks and1month post-operation had nosignificant difference （P＞0.05）.③CD8+：The cells numbers of2weeks and1month post-operation were respectively compared with pre-operation. Those were lowerthan pre-operation（P＜0.05）. The cells numbers of2weeks and1month post-operationhad no significant difference.④NK： Compared with pre-operation, the cells numbersof2weeks post-operation rose slightly, but there was no statistical difference. The level of NK cells of1month post-operation was significantly greater than pre-operation and2weeks post-operation （P＜0.05）.2. Ultrasonographic findings before and after treatment: the size of lesionspost-operation was smaller than pre-operation; the border of lesions pre-operation wasclear and the stereo sense was obvious. The border of post-operation was fuzzy and lackof stereo sense. Part of lesions showed low echo; the echo in most lesions ofpost-operation increased and was uneven. The arc or umbrella hyperechoic band wasvisible; the grade of pre-operative blood flow in the lesions was the level II-III; theblood flow signal in the lesions after RFA reached to the level0–I.Conclusions: The effect of ultrasound-guided RFA treatment for intra-hepaticmetastasis tumor is obvious. The treatment can change immune-suppression status ofpatients caused by the tumor and activate the body’s immune system. It has the certainimprovement effect for the immune function of patients with primary and secondaryliver cancer. The lesions image characteristics of post-RFA by ultrasound are strong. Itis easily distinct between normal liver tissue and the other lesions in the liver. Theexamination can be used as the first choice of RFA imaging examination duringpost-operation follow-up observation. Objective： To explore the significance of expression changes of vascularendothelial growth factor (VEGF) and microvessel density (MVD) in the differentperiods of residual tumors of rabbits liver VX2tumor after radiofrequency ablation（RFA）.Methods: We chose2experimental rabbits randomly in25health rabbits, VX2 tumor was implanted into their legs to reserve tumor. VX2tumor was implanted in theliver of the rest of23experimental rabbits under ultrasonographic guidance. About2weeks the models of rabbits VX2liver tumor were set up. The successful models ofrabbits VX2tumor were divided into5groups randomly: group A (control group,without RAF treatment)(n=3) and RFA treatment group (n=20). Every rabbits in B，C，D,E group were subjected to RFA treatment. Rabbits VX2tumor-remnant models wereremained by controlling the damage scope under ultrasonography at2/3of the largestradius of the tumor. The rest of20rabbits were divided into4groups randomlyaccording to their different time after treatment. There were group B (2hours afterRFA)，group C (1week after RFA)， group D (2weeks after RFA) and group E (4weeks after RFA). There were5rabbits in every group. The tumor-bearing rabbits wereexecuted after taking ultrasonographic examination. Cut the samples. The expressionstatus of VEGF and MVD in the tumor of group A and the tumor-remnant tissues ofgroup B-E was detected by immuno-histochemical techniques.Results:1.The ultrasonographical results: At14-21days the ultrasonographicresults showed23experimental rabbits were inoculated successfully after inoculation. Itshowed the round or circular hypo-echo nodules in liver，which had clear borders, nocapsule echo, rich blood flow signals and artery frequency spectrum.3rabbits werechosen randomly and executed. HE stained cells showed the cancer cells had nesteddistribution，large size，irregular arrangement，and large and deeply stained nuclei. Thatmeant the success of liver implantation.2.RFA the postoperative ultrasound results:0h after operation, the ultrasoundshowed the damaged area of tumor had irregular hyper-echo, unclear borders, irregularshape. Color Doppler Flow (CDF) and Color Doppler Energy (CDE) could not detectblood flow signal. The tumor size after1w,2w,4w was similar to pre-operation. Theultrasound showed irregular hyper-echo and little irregular anechoic in the center. CDFwas no significant blood flow signal. Blood flow signals could be seen in part of tumorby CDE when4w.3. Pathological mechanism results： Group A tumor tissue and group B-E residualcancer tissue showed the cancer cells had large and deeply stained nuclei，irregulararrangement，and nested distribution. In the tissue of group B-E treated by RFA, centralcarbonized tumor tissue showed coagulation necrosis,nuclear fragmentation, nucleardissolved and caryolysis, and many apoptotic cells and neutrophile granulocyte in theperipheric tissue, surrounded by lymphocyte and a little of fibrous tissue.After4weeks by RFA,the area of liquefaction necrosis extended，old inflammatory responseband replaced with fibrous band and began to thrombusize.4.Immunohistochemical results: VEGF and MVD of group A in HCC tissueshowed high expression, respectively (0.72±0.23)%and (24.39±4.36)%; the positiveexpression rates of VEGF and MVD of group B in residual cancer tissue were (0.43±0.14)%and (11.63±3.62)%; the positive expression rates of VEGF and MVD of groupC in residual cancer tissue were (0.39±0.15)%and (12.17±3.52)%; the positiveexpression rates of VEGF and MVD of group D in residual cancer tissue were (0.32±0.13)%and (11.7±3.27)%; the positive expression rates of VEGF and MVD of groupE in residual cancer tissue were（0.89±0.35)%and (31.65±5.29)%. VEGF and MVDof group B-E in the tumor tissue treated with RFA showed low expression.Conclusion: In the short time (2w) RFA can destruct the tumor blood vessels andinhibit angiogenesis of residual tumor tissue to reach the curative effect of reducingtumor. But chronic hypoxia can induce angiogenesis of new blood vessels andrecurrence of residual tumor. At this time the patients need further treatment. |
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