117例肝癌患者外周血调节T细胞水平及其临床意义

背景与目的:CD4 CD25 T细胞又称为调节性T细胞(Treg),是一群具有免疫抑制功能的T细胞亚群.近来的研究表明Treg能够显著地抑制免疫反应,导致肿瘤细胞的免疫耐受.然而,Treg在肝癌临床中的意义目前尚未阐明.本研究旨在探讨Treg水平与肝癌临床病理特征及预后的关系.方法:采用前瞻性研究设计,117例原发性肝癌患者于1999年1月至2000年12月住院且首次行肝癌根治性手术切除,术前用流式细胞仪检测其外周血Treg水平.术后随访至2005年12月30日.分析外周血Treg水平与肝癌临床病理特征及生存率的关系.40例正常对照来自健康献血者.结果:肝癌患者外周血中Treg的水平为(12.54±4.69)%,正常对照组为(8.81±1.98)%,两者比较差异有显著统计学意义(P＜0.01).全组1、3、5年生存率分别为83.8%、49.6%、35.9%.在单个病灶的患者中,Treg水平与肿瘤的边界有关,肿瘤边界不清楚者Treg水平显著增高;外周血Treg水平与其它临床病理特征无关.外周血Treg水平增高的患者预后差.结论:肝癌患者外周血Treg比例升高是影响预后的独立危险因素.

Clinical significance of the proportion of CD4+CD25+ regulatory T cells in peripheral blood of hepatocellular carcinoma patients: a report of 117 cases

BACKGROUND & OBJECTIVE: CD4+CD25+ regulatory T (Treg) cells, a subset of T cells, can suppress immune responses. Recent studies showed that Treg cells may significantly suppress immune responses, and lead to immune tolerance of tumor cells. However, the clinical significance of Treg cells in hepatocellular carcinoma (HCC) is still unclear. This study was to investigate the correlations of the proportion of Treg cells in peripheral blood to clinical characteristics and prognosis of HCC. METHODS: The proportion of Treg cells in peripheral blood of 117 HCC patients, who underwent radical resection in Cancer Center of Sun Yat-sen University from Jan. 1999 through Dec. 2000, was detected by flow cytometry before operation. The proportion of Treg cells in peripheral blood of 40 healthy blood donors was detected as control. All the patients had been followed up till Dec. 30th, 2005. The correlations of Treg cell proportion to clinicopathologic characteristics and prognosis of HCC were analyzed. RESULTS: The proportion of Treg cells in peripheral blood was significantly higher in HCC group than in control group [(12.54+/-4.69)% vs. (8.81+/-1.98)%, P < 0.01]. The 1-, 3-, and 5-year survival rates of the HCC patients were 83.8%, 49.6%, and 35.9%, respectively. In the 92 patients with single tumor, the proportion of Treg cells was significantly lower in the patients with clear tumor margin than in those with unclear tumor margin [(12.18+/-4.76)% vs. (15.52+/-5.45)%, P < 0.05]. The proportion of Treg cells had no correlations to other clinicopathologic characteristics of HCC (P>0.05). The 5-year survival rate was significantly higher in the patients with high proportion of Treg cells than in those with low proportion of Treg cells (43.9% vs. 28.3%, P = 0.047). CONCLUSION: The elevation of the proportion of circulating Treg cells is an independent prognostic factor of HCC.