The Alterations Of Immunological State In Patients With Primary Liver Carcinomas Before And After Transcatheter Arterial Chemoembolization And The Effects Of The Traditional Chinese Medicine On Their Immunological State

Objective: The aim of this study was to demonstrate the alterations of immunological state and the several cytokines in patients with primary liver carcinomas (PLC) before and after transcatheter arterial chemoembolization (TACE) therapy, and to reveal the defect of immunological state on patients with PLC. We also assessed the effects of the traditional Chinese medicine on immunological state and evaluated the clinical efficacy of Chinese medicine combined with TACE on liver cancer therapy. Methods: Patients with PLC in this study were hospitalized in the gastroenterology department of Hebei Tumer Hospital from 2003 to 2004. According to the revised diagnostic criteria and clinical stage criteria in the 2001 China National Hepaocarcinoma Academy, we selected 60 PLC patients(male 42, female 18, 50.76±10.89 years old) including Ⅱand Ⅲstages of PLC patients. All patients had no opportunity for operation and no intervention of other therapies, and predictive survival time of patients was over 3 months. The PLC patients were randomly divided into 3 groups, group A: TACE plas Boerning (Z20023388) 4 capsules, three times a day for 4 weeks; group B: TACE plas Fufangbanmaojiaonang (Z19993294) 4 capsules, three times a day for 4 weeks; group C: TACE alone. The population data of every group had no statistical difference in sex, age, and clinical characteristic. We also selected 30 healthy(male 18, female 12, 48.97±11.99 years old) as the control group. Before and after TACE and medicine administration, the CD4~+ and CD8~+ cells population and NK cells and the cytokines of peripheral blood mononuclear cells (PBMCs) including interleukin-4(IL-4),interleukin-18(IL-18),interferon-gamma(INF-γ) and transforming growth factor-beta (TGF-β) were detected by the Flow-cytometry (FCM) method. The radio-immonoassay (RIA) method was used to detect the cytokines including interleukin-2 (IL-2) and tumor necrosis factor-alpha (TNF-α) in the serum. Results: 1 The propotions of CD4~+, NK cells and the contents of IL-18, IL-2, TGF-βand IFN-γwere lower (P<0.05) in the patients with PLC than that of healty subjects, while the propotion of CD8+and the contents of IL-4 and TNF-αwere higher (P<0.05). 2 After 1 week of the TACE therapy, the propotions of CD4~+, NK cells and the contents of TGF-β, IL-18 and IFN-γincreased (P<0.05) while the propotion of CD8~+ and the contents of IL-2, IL-4 decreased (P<0.05), the content of TNF-αdecreased(P>0.05) compared with that before TACE. After 1 month of the TACE therapy, the propotions of CD4+, NK cells and the contents of TGF-β, IL-2, IL-18 and IFN-γincreased (P<0.05), the content of TNF-αincreased (P>0.05) while the propotion of CD8+ and the content of IL-4 decreased (P>0.05) compared with that before TACE. 3 The difference of T cell subgroups, NK cells, the cytokines of PBMC and of the serum in PLC patients (after TACE) before and after the traditional Chinese medicine: the propotion of CD4+ and the contents of IL-2 and IFN-γincreased (P<0.05) among the patients with BANMAO, the propotion of NK and the contents of TGF-β, TNF-αand IL-18 increased (P>0.05) while the propotion of CD8+ and the content of IL-4 decreased (P>0.05). The propotions of CD4+, NK cells and the contents of IL-2, TGF-β, IFN-γand IL-18 increased (P<0.05) among the patients with BOERNING while the propotion of CD8+ decreased (P<0.05), the content of IL-4 decreased (P>0.05), the content of TNF-αincreased (P>0.05). 4 The difference of T cell subgroups, NK cells, the cytokines of PBMC and of the serum between the PLC patients (after TACE) with the medicine and the patients (after TACE) without medicine: the propotions of CD4+, NK cells and the contents of TGF-β, IL-4 were of no statistics difference (P>0.05), the contents of IL-2,IL-18 and IFN-γincreased (P<0.05) while the propotion of CD8+ and the content of TNF-αdecreased...