Effect of transcatheter renal arterial embolization combined with cryoablation on regulatory CD4 +CD25 + T lymphocytes in the peripheral blood of patients with advanced renal carcinoma

摘要

Objective: To analyze the effect of Argon-Helium cryosurgery (AHCS) combined with transcatheter renal arterial embolization (TRAE) on the differentiation of regulatory CD4 + CD25 + T cell (Treg) and its implication in patients with renal carcinoma. Methods: Seventy seven patients are included in the study, and divided into two groups: TRAE group (n=45, receiving TRAE only) and TRAE+cryoablation group (n=32, receiving cryoablation 2-3weeks after TRAE). The percentage of Treg cells and T lymphocyte subsets (CD4 +T, CD8 +T, and CD4 +T/CD8 +T) in the peripheral blood is measured by flow cytometry previous to the therapy and 3months after therapy. Meanwhile, the extent of tumor necrosis is measured by MRI or CT 1month after therapy. Results: The percentages of Treg cells of patients in TRAE+cryoablation group decrease from (6.65±1.22)% to (3.93±1.16)%, (t=42.768, P0.01), and the percentages of CD4 +T and CD4 +T/CD8 +T increase significantly (P0.01). However, the results of patients in TRAE group show that the percentages of Treg, CD4 +T, CD8 +T and CD4 +T/CD8 +T increase slightly although the differences had no statistical significance (P0.05). The tumor necrosis rate of TRAE+cryoablation group is 57.5%, significantly higher than those of TRAE group, which shows 31.6% (t=6.784, P0.01). The median survival duration of the TRAE+cryoablation group is 20months, significantly longer than that of the TRAE group (χ 2=7.368, P0.01). The decreasing extent of Treg cells is correlated with tumor necrosis rates (r=0.90, P0.01) and life time (r=0.67, P0.01). Conclusion: The therapy of TRAE combined with cryoablation contributes to reduce the percentage of Treg cells and improve the immune situation of patients with renal cell carcinoma, which consequently increase tumor necrosis rate and prolong the patients' survival duration.