In a small study of 30 liver‑cancer patients, adding the peptide thymosin‑alpha‑1 (1.6 mg injected under the skin twice a week for four weeks) to standard chemo‑embolization raised the percentages of key T‑cell types and boosted cellular autophagy markers for the first few weeks, but the effect faded by three months.

<b>Objective:</b> To investigate the effect of transcatheter arterial chemoembolization(TACE)combined with thymosin alpha1(T&#x3b1;1)on the autophagy of immune cells from advanced hepatocellular carcinoma. <b>Methods:</b> A total of 30 patients with advanced liver cancer enrolled in Lishui Central Hospital from September 2015 to June 2016 were collected in this study. The average age of patients was 16-75(56&#xb1;12) years. All patients were treated with TACE after enrolled in hospital in a week. Patients were divided into TACE group and TACE+ T&#x3b1;1 treatment group(15 cases in each group). Patients in TACE group received a conventional treatment, without any immunotherapy, while the TACE+ T&#x3b1;1 treatment group accepted TACE following a subcutaneously injection of 1.6 mg T&#x3b1;1 twice a week for 4 weeks. Flow cytometry was used to detect the T cell subsets in two groups both before and after TACE treatment for 1, 4 weeks and at 3 months follow-up. Peripheral blood mononuclear cells (PBMC) were isolated by density gradient centrifugation. The expression of Beclin-1, LC3 protein and mRNA were detected by Western blot (WB) and PCR respectively. <b>Results:</b> There was no statistical difference of the percentage of CD3(+) , CD4(+) , CD8(+) T cell subsets and Beclin-1, LC3 protein and mRNA expression between the two groups before TACE treatment (<i>P</i>&gt;0.05). The percentage of CD3(+) , CD4(+) , CD8(+) T cell subsets in TACE+ T&#x3b1;1 group at 1 week post-TACE treatment (58.45%&#xb1;16.34%, 38.33%&#xb1;15.16%, 27.31%&#xb1;12.54%), at 4 weeks post-TACE treatment (62.38%&#xb1;18.62%, 43.19%&#xb1;13.86%, 29.54%&#xb1;10.33%) and 3 months follow-up (64.15%&#xb1;13.76%, 41.28%&#xb1;14.65%, 29.38%&#xb1;15.65%) were statistically higher than those in TACE group at 1 week post-TACE treatment (53.71%&#xb1;11.17%, 32.12%&#xb1;10.53%, 24.45%&#xb1;13.72%) at 4 weeks post-TACE treatment (52.12%&#xb1;14.26%, 31.16%&#xb1;15.43%, 23.39%&#xb1;15.33%) and 3 months follow-up (54.28%&#xb1;13.15%, 32.17%&#xb1;14.98%, 24.34%&#xb1;14.12%) (<i>P</i>&lt;0.05). The Beclin-1, LC3 protein and mRNA expression in TACE+ T&#x3b1;1 group at 1 week post-TACE treatment (protein: 0.57&#xb1;0.08, 2.26&#xb1;0.36, mRNA: 0.62&#xb1;0.11, 2.69&#xb1;0.27), at 4 weeks post-TACE treatment (protein: 0.66&#xb1;0.09, 3.11&#xb1;0.45, mRNA: 0.78&#xb1;0.13, 3.43&#xb1;0.61) were higher than those in TACE group at 1 week post-TACE treatment (protein: 0.45&#xb1;0.16, 1.43&#xb1;0.30, mRNA: 0.52&#xb1;0.15, 1.15&#xb1;0.37), at 4 weeks post-TACE treatment (protein: 0.51&#xb1;0.13, 1.81&#xb1;0.35, mRNA: 0.56&#xb1;0.10, 1.98&#xb1;0.41) ( <i>P</i>&lt;0.05). But there was no statistically significant difference in the expression of Beclin-1 and LC3 in two groups at 3 months follow-up (<i>P</i>&gt;0.05). <b>Conclusions:</b> TACE combined with T&#x3b1;1 significantly increase the level of autophagy in the immune cells of patients with advanced primary hepatocellular carcinoma.