原发性肝癌患者外周血和癌组织中调节性T细胞数量及其临床意义

目的 探讨原发性肝癌患者外周血中调节性T细胞(Treg)占CD4+T细胞(Treg/CID4+)比值和肝癌组织中Treg数量及其临床意义.方法 63例原发性肝癌患者均行根治性手术切除,采用流式细胞术检测患者手术前外周血中Treg/CD4+比值,用免疫组织化学方法检测肿瘤组织中Treg的表达.结果 原发性肝癌患者外周血中Treg/CD4+比值显著高于乙型肝炎患者(P<0.01)及正常对照组(P<0.01).癌组织中Treg数量为(15.69±13.29)个/mm2,癌旁肝组织、10例乙型肝炎肝组织、10例正常肝组织中未见或极少见Treg.外周血中Treg/CD4+比值与癌组织中Treg数量呈正相关(P=0.024).外周血和癌组织中Treg数量高者,术后5年生存率低(P值分别为0.042、0.019);癌组织中Treg数量高者,术后5年无瘤生存率低(P=0.001).结论 原发性肝癌患者外周血和组织中调节性T细胞水平升高;外周血中Treg/CD4+比值及癌组织中Treg数量可作为预测患者根治术后预后的免疫学指标.

Clinical significance of regulatory T cells proportion in the peripheral blood and tmnor tissue in primary hepatocellular carcinoma

Objective To investigate the clinical significance of the amount of regulatory T cells (Treg) in the peripheral blood CD4+ cells and tumor tissue in primary bepatocellular carcinoma (HCC).Methods From January 1999 to December 2000, 63 HCC patients underwent radical resection in Sun Yat-sen University Cancer Center. Trega in those patients were detected in the samples of preoperative peripheral blood by flow cytometry and also in tissue samples of the resected tumors by immunohistochemistry. All patients had been followed up till Dec 30, 2005. The correlations of Treg amount in the peripheral blood CD4+ cells and tumor tissue with clinicopathologic characteristics and prognosis of HCC were analyzed.Results The proportion of Treg,/CID4+ in the peripheral blood was significantly higher in the patients with HCC than that in those with HBsAg positive ( P < 0.01 ) and in the normal controls ( P < 0.01 ). The mean number of Treg in tumor tissue was ( 15.69 ± 13.29)/mm2, but none or very few Treg was detected in the normal liver tissue, para-cancerons liver tissue, and HBV-infeeted liver tissue. The proportion of Treg/CD4+ in the peripheral blood was significantly positively correlated with the number of Treg in tumor tissue (P =0. 024). The 5-year survival in patients with high amount of Treg in both peripheral blood and tumor tissue was significantly poorer than that in the patients with low amount of Treg ( P = 0.042, 0.019). The 5-year disease-free survival rate was significantly lower in the patients with high amount of Treg in tumor tissue than that in the patients with lower amount ( P = 0. 001 ). Conclusion Regulatory T cells in the circulatory blood and tumor tissue are increased in patients with bepatocellular carcinoma. The increased amount of regulatory T cells either in peripheral blood or in the tumor tissue is pertaining to poor prognosis. Detection of regulatory T cells both in the preoperative peripheral blood CD4+ cells and tumor tissue may be used as a potential immunological prognostic indicator for the bepatocellular carcinoma patients after radical resection.