Objective To explore the immunity of patients with small hepatocellular carcinoma ( HCC) , and the impact of surgical resection (SR) and radiofrequency ablation (RFA) on it. Methods The frequency of circulating natural killer ( NK) cell subsets and T lymphocyte subsets and their CD25 and perforin were measured by flow cytometry. Results The proportion of NK cells was significantly lower in small HCC patients before their treatment with SR or RFA than that in healthy individuals (all P<0.05) , whereas the proportion of CD56bniht subsets with less cytotoxic was opposite ( all P < 0.05). Small HCC patients who received SR treatment had an increased NK cell frequency (P <0.05) , and those received RFA treatment had a decreased CD56b"ghl cell frequency (P<0.01). Compared with healthy individuals, the level of CD25 on helper T cells was significantly increased in small HCC patients before their treatment with SR or RFA ( all P < 0.01), and decreased significantly after SR or RFA treatment ( all P < 0. 05 ) , but still higher than that in healthy individuals (all P <0.01). Small HCC patients had a higher level of T cells, but comparable level of helper T cells and cytotoxic T cells and the perforin expressed on NK cells or T cells than healthy individuals, neither SR nor RFA affected them. Conclusions The proportion of circulating immunocytes and the expression of their functional molecules are altered in small HCC patients, but recovered to some extent by surgical resection or radiofrequency ablation.%目的 观察小肝癌患者外周免疫状态的变化及手术切除、射频消融治疗的影响.方法 采用流式细胞术检测健康人及小肝癌患者手术切除和射频消融前后外周血NK细胞、T淋巴细胞亚群的比例及其CD25、perforin分子.结果 小肝癌患者手术切除和射频消融前NK细胞的比例低于健康人(P均＜0.05),低杀伤功能的CD56brightNK细胞亚群的比例则高于健康人(P均＜0.05)；手术切除肿瘤后NK细胞比例上升(P＜0.05),而射频消融后CD56brightNK细胞比例降低(P＜0.01).小肝癌患者手术切除前和射频消融前CD25+辅助性T细胞(Th细胞)的比例高于健康人(P均＜0.01),手术切除或射频消融后降低(P均＜0.05),但仍高于健康人(P均＜0.01)；与健康人相比,小肝癌患者T细胞比例升高(P＜0.05),而Th细胞及杀伤性T淋巴细胞(Tc细胞)的比例、perforin+ NK细胞及perforin+T淋巴细胞的比例相近(P均＞0.05),手术切除或射频消融治疗后没有明显改变(P均＞0.05).结论 小肝癌患者外周免疫细胞亚群比例及功能分子表达水平发生改变,手术切除或射频消融后获得一定恢复.
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