Department of Regenerative Surgery, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.
Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan.
J Hepatobiliary Pancreat Sci. 2016 May;23(5):298-304. doi: 10.1002/jhbp.342. Epub 2016 Apr 4.
Preoperative transarterial immunoembolization (TIE) for hepatocellular carcinoma (HCC) is effective for preventing recurrence. We aimed to investigate the intratumoral and peritumoral M1 macrophage-induced immune response following TIE treatment.
We compared 13 patients treated with TIE between 2003 and 2009 (TIE group) and 13 patients treated with surgery alone during the same period of time at our institute (control group) using an immunohistological study with CD68 and CD163 antibodies.
No significant differences in clinicopathological characteristics, except for surgical time, were observed between the two groups. The 3-year recurrence-free survival outcome of the TIE group was quite different from that of the control group (100% vs. 38.5%, P = 0.034). In the histological investigation, lytic necrosis and coagulation necrosis of the main tumor along with the presence of multinuclear giant cells were observed in 10 of the 13 patients in the TIE group. The immunohistological study showed that not only the numbers of intratumoral CD68(+) cells, but also the numbers of intratumoral and peritumoral CD8(+) cells were significantly increased in the TIE group.
The suppression of tumor recurrence induced by preoperative TIE might be induced by intratumoral M1 macrophages that are activated by OK-432 and fibrinogen.
术前经肝动脉免疫栓塞（TIE）治疗肝细胞癌（HCC）可有效预防复发。我们旨在研究 TIE 治疗后肿瘤内和肿瘤周围 M1 巨噬细胞诱导的免疫反应。
我们比较了我院 2003 年至 2009 年间接受 TIE 治疗的 13 例患者（TIE 组）和同期接受单纯手术治疗的 13 例患者（对照组），采用 CD68 和 CD163 抗体免疫组化研究。
两组患者的临床病理特征除手术时间外无显著差异。TIE 组患者的 3 年无复发生存率明显优于对照组（100% vs. 38.5%，P = 0.034）。组织学检查发现，TIE 组 13 例患者中有 10 例主瘤出现溶解坏死和凝固性坏死，并有多核巨细胞存在。免疫组化研究显示，TIE 组不仅肿瘤内 CD68（+）细胞数量，而且肿瘤内和肿瘤周围 CD8（+）细胞数量均显著增加。
术前 TIE 抑制肿瘤复发的作用可能是由 OK-432 和纤维蛋白原激活的肿瘤内 M1 巨噬细胞引起的。
