Huang Kai Wen, Jayant Kumar, Lee Po-Huang, Yang Po-Chih, Hsiao Chih-Yang, Habib Nagy, Sodergren Mikael H
Department of Surgery & Hepatitis Research Center, National Taiwan University Hospital, Taipei 10051, Taiwan.
Centre of Mini-invasive Interventional Oncology, National Taiwan University Hospital, Taipei 10051, Taiwan.
J Clin Med. 2019 Mar 19;8(3):385. doi: 10.3390/jcm8030385.
Hepatocellular carcinoma (HCC) often develops on a background of chronic inflammation and a complex immunosuppressive network with increased regulatory T cells, impaired CD8⁺ T cells and the secretion of immunosuppressive cytokines. Previous clinical studies have reported a superior disease-free survival (DFS) following a radiofrequency-based ablation or resection in HCC tumours compared to conventional liver resection techniques. The aim of this study was to investigate whether there is any correlation with the use of a radiofrequency-assisted liver resection and clinical outcome.
Patients' peripheral blood was collected prior and 7 days following surgery from patients undergoing a liver resection for HCC. There were 5 liver resections performed using CUSA and 6 liver resections with the RF-based device, Habib 4X. The primary endpoint of the study was to assess the immunological parameters of circulating immune cell populations as well as serum cytokines. The Student's -test, chi-square or Fisher's Exact test were applied for statistical comparisons, as appropriate.
Patients undergoing an RF-assisted liver resection with Habib 4X had a significant decrease in the inhibitory Treg cells ( = 0.002) and a significant increase in CD8⁺ T lymphocytes ( = 0.050) and CD4⁺CD45RO⁺/CD4⁺ memory T cells ( = 0.002) compared to those patients undergoing a liver resection with CUSA. It was also noted that the RF-assisted liver resection group had a significant decrease in circulating TGF-ß ( = 0.000), IL10 ( = 0.000) and a significant increase in IFN-gamma ( = 0. 027) and IL-17 compared to the CUSA group.
A liver resection with RF-based device Habib 4X was associated with positive immunomodulatory changes in circulating immune cells and circulating cytokines which could explain the significant improvement in DFS.
肝细胞癌（HCC）通常在慢性炎症和复杂的免疫抑制网络背景下发生，其特征包括调节性T细胞增加、CD8⁺T细胞功能受损以及免疫抑制细胞因子的分泌。先前的临床研究报告称，与传统肝切除技术相比，基于射频的消融或切除治疗HCC肿瘤后的无病生存期（DFS）更优。本研究的目的是调查射频辅助肝切除的使用与临床结果之间是否存在任何相关性。
在接受HCC肝切除手术的患者术前及术后7天采集外周血。其中5例使用超声外科吸引器（CUSA）进行肝切除，6例使用基于射频的设备Habib 4X进行肝切除。本研究的主要终点是评估循环免疫细胞群体的免疫参数以及血清细胞因子。根据情况，采用学生t检验、卡方检验或Fisher精确检验进行统计学比较。
与使用CUSA进行肝切除的患者相比，使用Habib 4X进行射频辅助肝切除的患者抑制性调节性T细胞显著减少（P = 0.002），CD8⁺T淋巴细胞（P = 0.050）和CD4⁺CD45RO⁺/CD4⁺记忆T细胞显著增加（P = 0.002）。还注意到，与CUSA组相比，射频辅助肝切除组循环转化生长因子-β（TGF-β，P = 0.000）、白细胞介素10（IL-10，P = 0.000）显著降低，干扰素-γ（IFN-γ，P = 0.027）和白细胞介素-17显著增加。
使用基于射频的设备Habib 4X进行肝切除与循环免疫细胞和循环细胞因子的正向免疫调节变化相关，这可以解释DFS的显著改善。
