慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究

目的分析慢性乙型肝炎(CHB)、乙肝肝硬化(LC)、乙肝肝癌(HCC)患者血清中Th1/Th2型细胞因子水平变化,为慢性乙型肝炎至肝癌的发生发展过程中的免疫变化研究提供线索,并为患者的临床治疗研究提供免疫学指标。方法选取2010年2月-2011年11月于首都医科大学附属北京佑安医院就诊的40例CHB患者、40例LC患者、53例HCC患者,用Luminex技术检测血清中Th1类细胞因子[白细胞介素(interleukin,IL)-12、干扰素(interferon,IFN)-γ和肿瘤坏死因子(tumor necrosis factor,TNF)-α]水平及Th2类细胞因子(IL-4、IL-6和IL-10)水平,并将25例健康志愿者作为正常对照组进行比较。结果除TNF-α外,CHB组、LC组和HCC组Th1类IL-12、IFN-γ和Th2类IL-4、IL-6、IL-10细胞因子水平均低于正常对照组;CHB组中大部分Th1类和Th2类细胞因子都高于LC组和HCC组;HCC组中TNF-α细胞因子水平要高于CHB组、LC组。结论 CHB、LC和HCC患者体内Th1/Th2细胞因子分泌水平受到抑制,Th1/Th2平衡发生漂移,对HBV病毒的清除作用受到抑制。TNF-α在肝癌发生过程中发挥着重要作用。

The Th1/Th2 cytokines levels changes of chronic hepatitis,liver cirrhosis,hepatitis B patients with hepatocellular carcinoma

Objective To analyze Thl/Th2 type cytokine levels in serum of chronic hepatitis B （CHB）, liver cirrhosis （LC）, hepatitis B carcinoma （ HCC）, provide clues for the study of immune changes in chronic hepatitis to liver cancer occurrence and development, and also provide immunological parameters for the studies of clinical treatment. Methods 40 cases of CHB, 40 cases of hepatitis B-related LC, 53 cases of hepatitis B-related HCC from Feb. 2010 to Nov. 2011 in the Beijing Youan Hospital were collected. Luminex technology was used to detecte levels of Thl cytokines [ include inteleukin （IL）-12, interferon （IFN）-γ and tumor necrosis factor（TNF）- α] and Th2 cytokines （include IL- 4,IL-6 and IL-10）. As comparison, 25 healthy volunteers served as normal control group. Results Excepted TNF- α, the Thl cytokines （IL-12,IFN-γ） and Th2 cytokines （IL-4,IL-6 and IL-10） in CHB, LC and HCC patients were lower than those in normal control group. TNF-α in HCC group was higher than that in CHB group and LC group. Conclusion The secretion of Thl/Th2 cytokines are inhibited in CHB, LC and HCC. The balance of Thl/Th2 is drift. The role of HBV viral clearance is inhibited. TNF-α plays an important role in HCC process.