原发性肝癌患者细胞免疫功能变化及其与转归的关系

目的了解原发性肝癌(肝癌)患者细胞免疫功能变化及与临床转归的关系。方法应用流式细胞术检测22例肝癌患者T淋巴细胞亚群及CD8 T淋巴细胞CD28共刺激分子表达，酶联免疫吸附试验及放射免疫法检测血清白细胞介素-2(IL-2)、转化生长因子β1(TGFβ1)及白细胞介素-6(IL-6)水平，并与慢性乙型肝炎、肝硬化及正常对照比较。结果肝癌患者CD8 CD28-T淋巴细胞较正常增高，CD8 CD28 T淋巴细胞显著降低。肝癌、肝硬化及慢性乙型肝炎患者CD4 T淋巴细胞、CD4 ／CD8 比值、IL-2水平较正常明显降低，CD8 T淋巴细胞、IL-6、TGFβ1水平升高；肝癌患者CD4 T淋巴细胞、CD4 ／CD8 比值、IL-2水平低于慢性乙型肝炎，IL-6、TGFβ1水平高于慢性乙型肝炎及肝硬化患者；血清IL-6及TGFβ1水平与肝癌分期相关。结论肝癌患者存在明显的细胞免疫功能紊乱和抗肿瘤免疫功能低下，观察这些指标的变化对估价肝癌患者的抗肿瘤免疫功能以及预后将有帮助。【

The prognostic value of cellular immunity function in patients with hepatocellular carcinoma

OBJECTIVES: To study the changes of cellular immunity function in patients with hepatocellular carcinoma (HCC) and its correlation with disease severity. METHODS: T lymphocyte subsets and CD28 co-stimulation molecule in CD8+ T cells in 22 HCC patients were detected using three-color flow cytometry. Serum interleukin-2 (IL-2), transforming growth factor beta 1 (TGFbeta1), and interleukin-6 (IL-6) were determined by ELISA and radioimmunoassay. A group of 30 patients with chronic hepatitis B (CHB), liver cirrhosis (LC), or normal adults (NC) served as controls. RESULTS: Compared with NC, the number of CD8+CD28- T cells increased and CD8+CD28+ T cells decreased in patients with HCC. The number of CD4+ T cells, CD4+/CD8+ ratios, IL-2 level all decreased and CD8+ T cells, IL-6, TGFbeta1 levels all increased in patients with HCC, LC and CHB. The CD4+ T cells, CD4+/CD8+ ratios and IL-2 level in patients with HCC were lower than those with CHB. Serum IL-6 and TGFbeta1 in patients with HCC were higher than those with LC and CHB. The levels of IL-6 and TGFbeta1 correlated with the stages of the tumors. CONCLUSIONS: HCC patients have a cellular immunity dysfunction. Rectifying the imbalanced function could be a potential way for treating HCC. Measurement of these factors would be useful for early diagnosis and evaluating the prognoses of these patients.