Study On The Immune Response Of Microwave Ablation For The Treatment Of Hepatocellular Carcinoma And Prediction Of Recurrence

Objective:1.To study the relationship between microwave ablation and dynamic change of interferon ?,interleukin 6,interleukin 10 and interleukin 22 of hepatitis B virus related hepatocellular carcinoma patients.2.To study the relationship between microwave ablation and blood cells and liver function.3.To investigate whether some clinical characteristics and IFN-??IL-6?IL-10?IL-22 predict HCC recurrence after microwave ablation.Method: 1.Thirty-five HBV-HCC patients who underwent microwave ablation were enrolled in the study.Serial blood samples were collected twenty-four hours before and after MWA,seventy-two hours and one month after MWA.The serum levels of IFN-?,IL-6,IL-10 and IL-22 were measured by Elisa.The frequencies of IFN-?,IL-6,IL-10 and IL-22 secreted by peripheral blood mononuclear cell were measured by Elispot.3.All clinical information were collected during the treatment and regular follow-ups.Results: 1.The white blood cells,the percentage and absolute number of neutrophil and neutrophil to lymphocyte ratio of HCC who underwent the MWA were significantly increased at twenty-four hours after MWA,then decreased at seventy-two hours after MWA,while the percentage and absolute number of lymphocyte changeed in the opposite trend.2.Albumin decreased at twenty-four and seventy-two hours after MWA.ASTm,ALP,TBIL,CBIL and FBIL were significantly increased at twenty-four hours after MWA,then decreased at seventy-two hours after MWA.3.The results of Elisa showed the serum level of IFN-? was significantly increased at one month after MWA,but the results of Elispot showed no significant changes in the frequency of IFN-? secreted by PBMC.The serum level of IL-6 was significantly increased at twenty-four and seventy-two hours after MWA.And Elispot showed the frequency of IL-6 was increased significantly at twenty-four hours after MWA.The serum level of IL-10 was significantly increased at twenty-four after MWA.And Elispot showed the frequency of IL-10 was increased at twenty-four hours after MWA without any statistical significance.The serum level of IL-22 was increased at twenty-four after MWA without any statistical significance.And Elispot showed the frequency of IL-22 was increased significantly at seventy-two hours after MWA.4.Kaplan-Meier analysis showed that patients with higher levels of ?IL-10T2-T1 and lower level of ?IFN-?T4-T2 and ?IL-6 T3-T1 had significantly shorter disease-free survival(DFS).Multivariate Cox analysis revealed that a high serum level of ?IFN-?T4-T2(?0.5pg/m L;hazard ratio [HR] = 0.031;95% confidence interval [CI] = 0.001-0.672;P = 0.027)had a positive prognostic impact on DFS,while high serum level of ?IL-10T2-T1(?2.0 pg/m L;HR =25.184;95% CI = 1.183-535.978;P = 0.039)had a negative prognostic impact on DFS.Conclusion: 1.The promotion of tumor played dominantly in HCC patients at twenty-four hours after MWA.Proinflammatory factors were secreted to repaire the damaged liver tissuse.Then anti-tumor effect played dominantly at seventy-two hours after MWA.2.Part of the normal liver was injured during MWA.The liver cell integrity was damaged,and endocellular enzyme flowed into blood.And the biliary ducts were injured as well,so that bilirubin flowed into blood.3.Immunosuppression was lifted and anti-tumor immune response was promoted by MWA.4.?IFN-?T4-T2 and ?IL-10T2-T1 levels are independent prognostic factors for DFS in patients with HBV-related early HCC who underwent MWA.