Effect Of Radiofrequency Ablation On Immunocyte Subsets And Cytokines In Patients With Hepatocellur Carcinoma

Objective:The purpose of the present study was to evaluate whether radiofrequency ablation (RFA)might have an influence on immune status in liver cancer patients, and to investigate therelation of the immune influence by RFA and clinical characteristics (sex, age, BCLC stage,Child-pugh class, pathogeny, tumor marker, et al).Methods:We investigated the immunomodulatory effects exerted by RFA treatment in livercancer patients. Analysis of T lymphocytes，B lymphocyte and NK cells，and the populationof Thl/Th2cytokines of peripheral blood samples taken from30patients were detectedbefore RFA,5-7d after RFA, and28d after RFA.Results:For all patients, compared with RFA24h before RFA,5-7d after RFA NK cellsincreased significantly (t=-3.355, P=0.002). While Th1cytokines (IL-2, IFN-alpha,TNF-gamma) were increased significantly (t=-17.951, P＜0.01, t=-9.283, P＜0.01; t=-7.176,P＜0.01); Patients older than55years old1weeks postoperatively NK cells increased(t=-0.08732, P=0.045); Patients younger than55years old, CD4+, CD4+/CD8+, T cells NKcells significantly increased after treatment (t=-2.579, P=0.023; t=-3.301, P=0.006; t=-3.091,P=0.009); and the level of CD8+T cells decreased significantly (t=3.453, P=0.004). Malepatients1week after RFA, CD3+T, CD4+T cells, CD4+/CD8+cells, NK cells increasedsignificantly (t=-2.717, P=0.013; t=-3.398, P=0.003; t=-3.449, P=0.002; t=-3.189, P=0.004);and the level of CD8+T cells decreased significantly (t=4.833, P=0.000). BCLC stage0/A1week after RFA, the CD3+cells, CD4+T cells, CD4+/CD8+cells, NK level increasedsignificantly (t=-2.489, P=0.025; t=-4.276, P=0.001; t=-4.155, P=0.001; t=-3.001, P=0.009);and the level of CD8+T cells decreased significantly (t=5.197, P＜0.01). Patients with Child-Pugh A,1week after RFA, CD4+, CD4+/CD8+, T cells NK cells significantlyincreased,(t=-4.391, P＜0.01; t=-4.584, P＜0.01; t=-3.702, P=0.002); and the level ofCD8+T cells decreased significantly (t=5.566, P＜0.01). Patients with low load of hepatitisB virus,1week after RFA, CD3+T cells, CD4+T cells, CD4+/CD8+level increasedsignificantly (t=-3.517, P=0.008; t=-2.454, P=0.040; t=-2.549, P=0.034); and the level ofCD8+T cells decreased significantly (t=3.969, P,=0.004).Patients with reduced AFP,1weekafter RFA, CD4+, CD4+/CD8+, T cells NK cells increased significantly (t=-2.473, P=0.043;t=-2.867, P=0.024; t=-2.417, P=0.046); and the level of CD8+T cells decreased significantly(t=2.746, P=0.029).Complete ablation group patients1week after RFA, CD3+T cells,CD4+/CD8+, NK cells were significantly increased (t=-3.190, P=0.011; t=-2.451, P=0.037;t=-2.992, P=0.015); the level of CD8+T cells were decreased significantly (t=2.493,P=0.034). Incomplete ablation group after treatment,1weeks of NK cells was higher thanbefore treatment (t=-2.806, P=0.023). Incomplete ablation group,1month after RFA,Th2type cytokine(IL-4, IL-6, IL-10) were significantly higher than that before RFA(t=-2.360,P=0.046; t=-2.617, P=0.031; t=-3.836, P=0.005).Conclusion：Analysis of lymphocyte subsets and B lymphocyte by flow cytometry revealed thatafter RFA, no change was observed in all of the targeted patients. NK cells weresignificantly increased in all patients. When characterizing all the patients, immuneresponses against tumor were significant increased in patients younger than55yearsold,while no change was found in patients older than55years old. The immune responses ofmale were significantly increased,while no change was observed in female,suggesting abetter post-RFA immune competence in men than in women. Significant increased immuneresponses were found in BCLC stage0and A patients,while no change was observed inBCLC stage B to D patients. The immune responses of Child-Pugh A patients weresignificantly increased,while no change was observed in Child-Pugh B and worse patients.Significant increased immune responses were observed in patients with low HBV load,while no change was observed in HCV or metastatic cancer or alcoholic cirrhosis patients.The immune responses of patients with decreased tumor markers were obviously increased,while no change was observed in patients with increased or steady tumormarkers.In complete ablation group, we observed significant increased immune responses,while no change was observed in incomplete ablation group.