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目的探讨入肝血管区域性化学药物治疗（下称化疗）原发性肝癌的疗效机制。方法应用医学彩色图像分析，免疫组织化学染色，３ＨＴｄＲ掺入实验和乳酸脱氢酶释放测定等方法，对３６例接受全植入微泵肝动脉和门静脉输注化疗的原发性肝癌患者肿瘤浸润淋巴细胞的表型、组织密度，活化增殖功能和细胞毒活性进行检测。结果化疗后瘤体缩小获得二期切除者占６６６％（２４／３６）。其中Ｂ型超声和病理证实癌灶周围有明显包膜形成者占８３３％（２０／２４），且癌灶内浸润淋巴细胞面积平均光密度和体积密度平均值较化疗前显著增高（Ｐ＜００１），与化疗前和对照组比较，化疗后浸润淋巴细胞增殖活力虽有降低，但其浸润和抗肿瘤活性方面有显著改善；ＣＤ８＋、ＣＤ２５＋或ＨＬＡＤＲ＋亚群细胞呈高分布态势。结论入肝血管区域性化疗其机制不单纯涉及对肿瘤细胞的直接杀伤作用，而且可能与癌灶微环境内功能抑制的浸润淋巴细胞的功能调变密切相关
Objective To investigate the therapeutic mechanism of hepatocellular carcinoma with regional chemotherapy (hereinafter referred to as chemotherapy). Methods Forty-six patients with primary hepatocellular carcinoma who underwent transcatheter arterial and portal vein infusion chemotherapy were used in 36 cases with medical color image analysis, immunohistochemical staining, 3H-TdR incorporation assay, and lactate dehydrogenase release assay. The phenotype, tissue density, activated proliferation and cytotoxicity of tumor-infiltrating lymphocytes were examined. Results 66.6% (24/36) of the patients were treated with secondary tumor resection after chemotherapy. Among them, B-mode ultrasonography and pathology confirmed that the capsule formation around the lesions accounted for 83. 3% (20/24), and the mean optical density and volume density of infiltrating lymphocytes in the lesions were significantly higher than those before chemotherapy (P). <001), compared with before chemotherapy and control group, although the invasive lymphocyte proliferation activity after chemotherapy was reduced, but its infiltration and anti-tumor activity was significantly improved; CD8+, CD25+, or HLA-DR+ subpopulation cells were highly distributed situation. Conclusion The mechanism of local chemotherapy for hepatic vascular access is not simply related to the direct killing effect on tumor cells, but also may be closely related to the functional modulation of infiltrating lymphocytes in the microenvironment of cancer foci.