Changes in CD4 and CD8 after Interventional Management of Hepatocellular Carcinoma

Abstract

Introduction: Hepatocellular carcinoma (HCC) has many curative choices which in some circumstances are equal to or even better than surgery. These strategies for treatment of HCC may induce certain local effects which trigger distinct immunological responses that may have a systemic impact on the natural history of the tumour itself. These responses are validated through the measurement of specific immune cells in the systemic circulation. Aims & Methods: In this study, we tried to observe and analyze the immunological changes that accompany and follow HCC ablation by different procedures of radiological intervention and compare our results with the literature. This study was conducted on 50patients diagnosed with HCC who were referred to Tropical Medicine Department at Mansoura University Hospital, Egypt and 20 healthy volunteers as a control. The therapeutic strategy was selected according to the tumor stage and general condition. RFA was performed for 12 cases, PEI for 13, MWA for12 and TACE for 13 cases. All Patients were subjected to full history taking, clinical examination, liver function tests, serum alpha fetoprotein, abdominal ultrasonography, triphasic abdominal computerized tomography and lymphocyte subset assay by flow cytometry 1 day before, and 3 weeks after the treatment. Results: In the RFA group, CD4+ cells and CD4/CD8 ratio remarkably increased after treatment (P<0.001), and the CD8+ cells significantly decreased (P<0.002) with concomitant increase in the CD4+/CD8+ratio (P<0.001). In the PEI group, CD4+cells markedly increased after treatment (P<0.001), but there were no significant differences in CD8+cells and CD4/CD8 ratio. In the MWA group, CD4+cells markedly increased after treatment (P<0.001), with increase in CD4/CD8 ratio (P<0.007) but there were no significant differences in CD8+cells. In the TACE group, the CD4+cells and CD4/CD8 ratio dramatically decreased after treatment (P<0.001), and the CD8+cells increased significantly (P<0.001). Conclusion: Our study has proved the presence of a relationship between the immunity and the different modes of therapy in HCC patients and demonstrated a positive attitude towards increasing the immune cells following the ablation technique.