Study On The Changes Of Immune States In Patients With PHC Treated With High Intensity Focused Ultrasound(HIFU)

Objective: We detected the changes of immune indexes in the primary hepatocellular carcinoma (PHC) patients treated with high intensity focused ultrasound (HIFU) to investigate its influence on the patients' cellular immunity.Methods: 37 primary hepatocellular carcinoma patients were chosen to our study. Among them, 27 were male and 10 female. They were divided into three groups according to their states of the illness. Before HIFU, T cell subsets (CD3 +, CD4+, CD8+) in patients with PHC were determined with flow cytometry. Meanwhile, checked the patients' livers with color Doppler ultrasonography to observe the cancer nodules involving size, shape, boundary, internal echo feature and blood flow . Before HIFU, marked the puncture spots on the patients' skin and determined the distance from the cancer to the skin surface. Puncture the tumor tissues guided by ultrasonic wave B and tested positive rates of heat shock protein 70(HSP70) with flow cytometry. On the day performing HIFU, the patients were narcotized by general anaesthetic. Then began HIFU treatment. When HIFU finished, punctured thecancer nodules to test HSP70 at once. Four weeks after HIFU, CD3+^ CD4+^ CD8+ T cell subsets were rechecked .Results: ?After HIFU, general states of the patients were fine. ?After HIFU, the amounts of CD3+, CD4+ T cell subsets of the three groups were significantly high than those before HIFU(p <0.01), but the amounts of CD8+ T cell subsets had no significant changes before and after HIFU (p>0.05). (§) Comparisions among groups of the amounts of CD3+> CD4+^ CD8+ T cell subsets before and after HIFU: Among the three groups, the amounts of CD3+> CD4+ T cell subsets of group A(Stage I ) were significantly high than those of group B(Stagell) and group C (Stagelll) (CD3+: group A to group B, p<0. 05;group A to group C, p <0. 01; group B to group C, p>0. 05;CD4+:group A to group B, p>0.05;group A to group C, p <0. 01; group B to group C, p<0.05).But there were no differences among the three groups in amounts of CD8+ T cell subsets after HIFU (p>0. 05). ?Positive expression rates of heat shock protein 70: After HIFU, the positive expression rates of HSP70 were significantly high than those before HIFU (p <0.01),but there were no differences among the three groups (p>0.05).Conclusions: HIFU is a safe -. effective and microinvasive method in PHC local treatment. For early PHC patients, not only can HIFU ablate niduses completely, but also promote antitumor immunity. For inoperable advanced PHC patientsincluding those who had tumor thrombi in portal vein and (or) ascites, HIFU also can be performed to directly eradicate established tumors and efficiently induce their antitumor immunity as long as their general states permitted. At this point of view we can say that HIFU has a superiority over hepatectomy and TACE.