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  

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

作　　者：李升平[1] 彭启全[1] 丁童[2] 许静[2] 张昌卿[1] 冯凯涛[1] 李锦清[1] 

机构地区：[1]中山大学肿瘤防治中心肝胆科华南肿瘤学国家重点实验室,广州510060 [2]中山大学生命科学院生化系

出　　处：《中华肿瘤杂志》2008年第7期523-527,共5页Chinese Journal of Oncology

基　　金：广东省科技计划资助项目（2006836002014）

摘　　要：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／CD4^＋）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／mm^2，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。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 hepatocellular carcinoma （HCC）. Methods From January 1999 to December 2000, 63 HCC patients underwent radical resection in Sun Yatsen University Cancer Center. Tregs 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/CD4＋ 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）/ram2, but none or very few Treg was detected in the normal liver tissue, para-cancerous liver tissue, and HBV-infected 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 hepatocellular 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

关 键 词：肝肿瘤 Treg/CD4^+ 调节性T细胞 

分 类 号：R686[医药卫生—骨科学]