氩氦刀冷冻消融治疗乙型肝炎相关性肝细胞癌前后调节性T细胞的变化及其与患者预后的相关性  

Changes in regulatory T cells and their relation with prognosis of patients after argon-helium cryoablation for hepatitis B related-hepatocellular carcinoma

作　　者：周霖[1] 福军亮[2] 陆荫英[1] 高莹莹[2] 周春宝[2] 王春平[1] 安林静[1] 王新真[1] 苏淑慧[1] 冯永毅 王福生[2] 杨永平[1] 

机构地区：[1]解放军302医院肝癌治疗研究中心,北京100039 [2]解放军302医院全军传染病研究所,北京100039

出　　处：《解放军医学杂志》2010年第4期367-371,共5页Medical Journal of Chinese People's Liberation Army

基　　金：国家科技重大专项课题(2008ZX10002-018);军队医学杰出人才基金(04J020)

摘　　要：目的探讨乙型肝炎相关性肝细胞癌(HCC)患者外周血调节性T细胞(Treg)频率与疾病病程的关系;观察氩氦冷冻消融治疗对HCC患者外周血Treg频率的影响,分析Treg频率与患者预后的相关性。方法采用流式细胞仪检测101例HCC患者外周血Treg频率,分析Treg频率与HCC进展的关系。对其中34例患者进行氩氦冷冻消融治疗,检测治疗前和治疗后患者外周血Treg频率和甲胎蛋白(AFP)水平,分析二者的变化规律及与肿瘤进展的相关性。结果HCC巴塞罗那分期(BCLC分期)早期患者的Treg频率为6.89%±1.27%,中期患者为9.13%±1.36%,进展期患者为10.12%±2.04%,终末期患者为13.4%±2.81%。氩氦刀冷冻消融治疗后,17例肿瘤缓解患者的Treg频率较术前降低,其中7例术前AFP阳性(AFP>20ng/ml)的患者术后Treg频率和AFP水平均降低;14例肿瘤进展患者的Treg频率较术前明显升高,其中9例术前AFP阳性患者术后Treg频率和AFP水平随肿瘤进展而升高。结论HCC患者Treg频率随肿瘤进展而逐渐升高。氩氦刀冷冻消融治疗可降低HCC患者的Treg频率;对于氩氦刀冷冻消融治疗前AFP阴性的HCC患者,AFP不能发挥良好的指示作用,但Treg频率升高可以作为肿瘤进展的标志。Objective To investigate the correlation between the percentage of peripheral regulatory T cells （Tregs） and the course of hepatocellular carcinoma （HCC）,and analyze the prognostic implication of Tregs in HCC patients undergone argon-helium cryoablation.Methods The percentage of Tregs was determined by flow cytometry,and the correlation between the percentage of Tregs and progression of HCC was then studied.Of 101 patients with HCC,34 underwent argon-helium cryoablation.The Tregs percentage and alpha fetoprotein （AFP） levels in peripheral blood were detected before and after the cryoablation.Subsequently,the variation of Tregs percentage and AFP levels,and the correlation between their variation and the course of HCC was analyzed.Results According to the Barcelona-Clinic Liver Cancer （BCLC） classification,the Tregs was 6.89%±1.27% in patients in early-stage of HCC,9.13%±1.36% in intermediate-stage,10.12%±2.04% in advanced-stage,and 13.4%±2.81% in terminal-stage.After argon-helium cryoablation,the Tregs percentage in 17 patients with regressive tumor was lowered compared with that before cryoablation,and among them both the AFP level and Tregs percentage declined in 7 cases with pre-AFP level 20ng/ml.In addition,the Tregs percentage increased obviously in 14 patients with progression of tumor growth after cryoablation compared with that before cryoablation.Among them both the AFP level and Tregs percentage increased accompanying with the tumor progression in 9 cases with pre-AFP level 20ng/ml.Conclusions The Tregs percentage may increase accompanying progression of the tumor.Argon-helium cryoablation may reduce the Tregs percentage in HCC patients.Increased percentage of Tregs may be considered as a sign for tumor progression,while AFP can not precisely indicate tumor progression in AFP-negative HCC patients.

关 键 词：T淋巴细胞 调节性 癌 肝细胞 肝炎 乙型 慢性 冷冻外科手术 

分 类 号：R735.7[医药卫生—肿瘤]