Afro-Egypt J Infect Endem Dis 2015 June ; 5(2):94

 

Changes in CD4 and CD8 after Interventional Management of Hepatocellular Carcinoma

 

El-Sherbiny W,Abousamra NK,Diasty M, Shaltout SW

Tropical Medicine department, Faculty of Medicine, Menoufiya University ,Egypt

walidelsherbiny1@yahoo.com

 

ABSTRACT

Background and study aim : Hepato-cellular 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. In this study, we tried to observe and analyze changes in the peripheral immune cells that accompany and follow HCC ablation by different procedures of radiological intervention and compare our results with literature. So, this study may be useful with other criteria in the guidelines for the selection of the optimal therapeutic strategy for each patient. .

Patients and Methods: This study was conducted on about 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 for12 cases, PEI for 13, MWA for12 and TACE for 13 cases. All Patients were subjected to full history taking, clinical examination, liver function tests, anti HCV antibodies and HBS antigen by 3rd generation ELISA, serum alpha fetoprotein, abdominal ultrasonography, triphasic abdominal computerized tomo-graphy and lymphocyte subset assay by flow cytometry 1 day before, and 3 weeks after the treatment.

Results: Regarding the immunological status between control and HCC patients, there was a demonstrable difference in the number of cells in both groups, as the control group had higher levels of CD4+ and CD8+ values. 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 to find a relationship between immunity and different models of therapy in HCC patients and demonstrated a positive attitude towards increasing immune cells following ablation technique.