| Objective:Background:In recent years, transarterial chemoembolization (TACE) is widelyemployed due to its good efficacy and is used to treat hepatocellular carcinoma, especially in advanced liver cancer. It is well-known that the liver has dual blood supply from both the portal vein and the hepatic artery. However, the vascularization of hepatocellular carcinoma (HCC) is mostly dependent on the hepatic artery. As a new embolization agents Gelatin sponge particles possess sufficient embolization effects. So, treatment of the unresectable liver cancer with gelatin sponge particles (GSPs) shows its great advantage. The choice of embolic agents, the best diameter of embolic agents, the shape and behavior of embolic agents and whether the chemotherapeutic agents are able to play the best Synergistic therapeutic effect with GSPs is the key to improve the efficacy of TACE. Meanwhile, after TACE the size of tumor are decreased, so that a considerable part of unresectable liver cancer turn into resectable and increased the survival rate. In addition to, TACE can also enhance the anti-tumor immunity after operation. Recent studies have found that the tumor is surrounded by a large number of CD4+ CD25+ FoxP3 +regulatory T cells (Treg), by suppressing or killing effect of CD8 or CD4 T cells and inhibit the body's anti-tumor immunity. In contrary, removing off the Treg cells in mice with tumor can enhance the anti-tumor effect. Our previous studies have shown that the increasing number of regulatory T cells in HCC patients who have poor prognosis. The purpose of this study is to evaluate the expression effects of Treg when used GSPs as an embolic material for TACE in HCC. And also explore the significances about the changes of regulatory T cells and its effects on prognosis in patients with HCC.Methods:Thirty patients with biopsy-proven HCC recently underwent TACE with GSPs. We observed the frequency of Treg in peripheral blood and the functional changes before and after the treatment with flow cytometry. We also got the same data in 15 patients with liver cirrhosis, and 15 healthy people.Results:We observed that the difference of Treg cell frequency in HCC patients'peripheral blood before and 4 days,7 days after TACE were significantly.The frequency of Treg in CD4+ and CD25+ were 50.56±9.25% and 46.60±6.22%,33.58±8.12% and 31.15±7.37%,19.50±8.22% and 21.24±8.31% before treatments and 4 days,7 days after treatments, respectively.The difference between the groups was regarded as statistically significant (P<0.05). Separately,The frequency of CD4+ Treg and CD25+ were 3.82±0.66% and 6.11±1.42%,4.10±0.43% and 8.63±2.54% in Healthy people and liver cirrhosis patients。Conclusion:GSPs Treg in peripheral blood of HCC treatment significantly reduced the frequency, certified GSPs HCC chemoembolization particles on immune function has a positive regulatory role, may achieve good efficacy of this method one of the mechanisms... |
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