Evaluation on the immune effects and imaging of high intensity focused ultrasound in the treatment ofpancreatic carcinoma

Abstract

Objective To explore the immune effects of high intensity focused ultrasound （HIFU） in the treatment of pancreatic carcinoma and to investigate the imaging methods to evaluate HIFU＇s efficacy~ Methods A total of 32 patients with pancreatic carcinoma treated by HIFU were enrolled. The freeze-thaw antigen was prepared by freezing and thawing the cancer cells. HIFU antigen was prepared by cancer cells sonicated by HIFU. The killing effects of no antigen activated dendritic cells （DC） induced T lymphocyte （DC-T）, freeze-thaw antigen activated DC induced T lymphocyte （freeze-thaw antigen-DC-T） and HIFU activated DC induced T lymphocyte （HIFUantigen-DC-T） in autologous pancreatic cancer cells were detected by lactic dehydrogenase kit. The changes of immune indexes [-heat shock protein 70 （HSP70）, T helper lymphocyte Thl/Th2 and transforming growth factor-β （TGF-β] before and after HIFU treatment were determined by enzyme linked immunosorbnent assay （ELISA） method. The changes of clinical efficacy indexes [visual analogue scale （VAS）, performance status （PS） and carbohydrate antigen （CA） 19-9] before and after HIFU treatment were compared. The instant and recent （two months） efficacy of HIFU treatment were evaluated by contrast-enhanced ultrasonograph（CEUS） and computed tomography （CT）. The line q test was performed for comparision between groups, t-test was applied for comparision before and after treatment. Results Compared with freeze-thaw antigen, the killing effect of HIFU antigen-DC-T in autologous pancreatic cancer cells was higher （ 40. 24% ±45 10. 56% vs 46.93%±13.26%, q=3.44,P〈0.05）. HSP70 [（17.31±4, 75） ng/mlvs （22.84±5.56） ng/ml], Thl/Th2 （1.24±0.36 vs 1.47±0.31）, TGF-13 [（1.39±0.41） ng/ml vs （1.04±0. 38） ng/ml], VAS （3.97±1.32 vs 3.26±1.18）, PS （2.76±1.02 vs 2.21±0.86） and CA19-9 level[（135.39± 37.45） U/ml vs （114.82±30.51） U/ml] improved after HIFU treatment compared with those before treatment （t=4.278; 2. 739, 3. 542, 2. 268, 2. 332 and 2.409,allP〈0.05）. CEUSandCT showed that blood supply and the volume of the tumors reduced after HIFU treatment. Conclusions HIFU is effective in treating pancreatic carcinoma, improving immune status of patients and enhancing anti- tumor response. CEUS can real-time evaluate the efficacy of HIFU treatment. Key words: Pancreatic neoplasms;  Ultrasonic therapy;  Ultrasonography;  Dendritic cells