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目的探讨活化自体淋巴细胞(AAL)治疗对肝细胞癌患者免疫功能及预后的影响。方法采集66例肝细胞癌患者外周血,体外分离单个核细胞并扩增AAL自体回输后,检测治疗前后外周血白细胞总数及分类、淋巴细胞亚型;按肝癌分期评价患者治疗后4周的疗效。结果 AAL治疗后与治疗前比较,患者外周血白细胞[(5.97±2.24)×109/L vs.(5.00±1.76)×109/L,P=0.030]及淋巴细胞计数[(1.47±0.61)×109/L vs.(1.19±0.41)×109/L,P=0.016]显著升高,其中CD3+、CD8+T淋巴细胞亚群计数显著升高(P均=0.024),CD4+/CD8+比值显著下降(P=0.017)。Ⅰ期部分缓解病例占63.6%,明显高于Ⅱ期(P=0.023);Ⅱ期病情稳定病例占53.3%,明显高于Ⅲ期(P=0.011);Ⅲ期疾病加剧病例占52.0%,明显高于Ⅰ、Ⅱ期(P=0.009,P=0.028)。结论 AAL治疗对微小残余肿瘤的患者有益。以微转移为主要特点、瘤负荷小的Ⅰ、Ⅱ期肝癌患者采用AAL治疗效果显著。
Objective To investigate the effect of activated autologous lymphocyte (AAL) therapy on immune function and prognosis of patients with hepatocellular carcinoma. Methods The peripheral blood mononuclear cells of 66 patients with hepatocellular carcinoma were collected. Mononuclear cells were isolated from mononuclear cells in vitro and amplified by autologous transfusion of AAL. The total number and classification of peripheral blood leukocytes and lymphocyte subsets were detected before and after treatment. Efficacy. Results Compared with those before treatment, the number of peripheral blood leukocytes (5.97 ± 2.24 × 109 / L vs. 5.00 ± 1.76 × 109 / L, P = 0.030) and lymphocyte count (1.47 ± 0.61) × (P = 0.024), and the ratio of CD4 + / CD8 + decreased significantly (P <0.01), and the ratio of CD8 + T lymphocyte subsets significantly increased (P = 0.017). Stage Ⅰ partial remission cases accounted for 63.6%, significantly higher than stage Ⅱ (P = 0.023); stage Ⅱ stable disease cases accounted for 53.3%, significantly higher than stage Ⅲ (P = 0.011); stage Ⅲ disease exacerbated cases accounted for 52.0%, significantly Higher than Ⅰ, Ⅱ (P = 0.009, P = 0.028). Conclusion AAL treatment is beneficial for patients with minimal residual tumor. The main features of micrometastasis, small tumor load Ⅰ, Ⅱ liver cancer patients treated with AAL significant effect.