原发性肝癌患者CD4+CD25+CD127low调节性T细胞的检测及意义

探讨CD4+CD25+CD127low调节性T细胞（Tregs）在原发性肝细胞性肝癌（HCC）患者外周血中的变化及其临床意义。方法:采集40例乙型肝炎病毒（HBV）相关的HCC患者［巴塞罗那临床肝癌（BCLC）分期A期患者7例、B期患者8例、C期患者20例、D期患者5例］、35例慢性乙型肝炎（CHB）患者及28例正常健康人的外周抗凝血，应用CD4（PE-CY5）、CD25（FITC）、CD127（PE）三种特异性荧光抗体标记后，通过流式细胞术对CD4+CD25+CD127lowTregs水平进行三色荧光抗体检测。结果:HCC患者外周血CD4+CD25+CD127lowTregs占CD4+T细胞的百分比显著高于正常健康人（P<0.001）和CHB患者（P=0.017），CHB患者外周血CD4+CD25+CD127lowTregs占CD4+T细胞的百分比高于正常健康人（P=0.035）；HCC中BCLC分期为C期的患者外周血CD4+CD25+CD127lowTregs占CD4+T细胞的百分比显著高于A期患者（P=0.020）和B期患者（P=0.019）。结论:CD4+CD25+CD127lowTregs水平异常增高可能是HCC免疫逃逸的一个重要机制，且其变化水平与临床病情的进展存在一定的相关性。 

Detection of CD4+ CD25+ CD127low Regulatory T Cells in Primary Hepatocellular Carcinomaand Its Clinical Significance

To investigated the changes in CD4+CD25+ CD127low regulatory T cells (Tregs) in the peripheral blood of patients with hepatocellular carcinoma ( HCC ) and the clinical significance of these changes. Methods: Peripheral blood mononuclear cells from 40 patients with HBV-induced HCC (7 patients with stage A, 8 with stage B, 20 with stage C, and 5 with stage D, based on Barcelona Clinic Liver Cancer Staging Classification), 35 patients with chronic HBV infection, and 28 healthy controls were isolated and labeled with monoclonal antibodies to CD4, CD25, and CD127. Surface expression profiles were then determined by flow cytometry ( FCM ). Results: The percentage of CD4+CD25+ CD127low regulatory Tregs was higher in the CD4+T cell fraction from HCC patients than in the CD4+T cell fraction from both CHB patients ( P = 0.017 ) and healthy subjects ( P = 0.000 ). The percentage of CD4+CD25+ CD127low Tregs was higher in the CD4+T cell fraction from CHB patients than in that from healthy subjects ( P = 0.035 ). In addition, the percentage of CD4+CD25+ CD127low Tregs was higher in the CD4+T cell fraction from stage-C HCC patients than in that from stage-A HCC patients ( P = 0.020 ) and stage-B HCC patients ( P = 0.019 ). Conclusion: There was an abnormal elevation of circulating CD4+CD25+ CD127low Tregs, which may be an important mechanism for HCC immune evasion. This elevation was associated with the clinical stage and progression of HCC.