The Value of Interferon Combined with Hepatic Artery Chemoembolization and Portal Vein Chemotherapy in Preventing a Recurrence after Radical Resection for Hepatocellular Carcinoma

摘要

OBJECTIVE The change of cell immune function after hepatectomy of patients suffering from hepatocellular carcinoma (HCC) is usually neglected. The aim of this study was to explore the change of T cell subsets in HCC patients after hepatectomy, and to study the value of treatment with interferon (INF)combined with hepatic artery chemoembolization (HACE) and portal vein chemotherapy (PVC) to prevent recurrence after radical resection of HCC.METHODS Seventy-five HCC patients were treated with PVC and HACE at the 2nd week and 4th week after radical tumor resection. In the 2nd week after surgery, 33 pationts received INF treatment for one week. Seventy-two patients were followed up over three years. The effect of INF combined with HACE and PVC on the postoperative recurrence rate was compared with that of HACE and PVC treatment. Changes of T cell subsets in the peripheral blood were examined with labeled monoclonal antibodies before and after hepatectomy or with use of interferon. Forty cholecystolithiasis patients who received a cholecystectomy were used as controls.RESULTS CD3^+ and CD4^+ cells in the peripheral blood were reduced in patients with HCC. After hepatectomy, they declined further with a decrease in the CD4^+/CD8^+ ratio. The values returned to pre-operative level at the 4th week after surgery. The CD3^+ and CD4^+ cells and the CD4^+/CD8^+ ratio increased remarkably following the use of INF. The 1-, 2- and 3-year recurrent rates of patients treated with HACE, PVC and INF in combination were 0%, 6.2% and 15.6%, respectively, while those treated only with HACE and PVC were 5.0%, 12.5% and 27.5%, respectively.CONCLUSION Patients with HCC suffer from a marked immunosuppression, which become ever more severe after hepatectomy. The combined use of HACE, PVC and INF is superior in decreasing the recurrent rate to the combination of only HACE and PVC.