原发性肝癌患者T淋巴细胞亚群变化及其与CTCs、TTV及HBV-DNA的关系  

Changes of T lymphocyte subsets and its relationship with CTCs, TTV and HBV-DNA in patients with primary hepatocellular carcinoma

作　　者：陈佳佳[1] 万磊[1] 刘建军[1] 阚和平[1] CHEN Jia-jia;WAN Lei;LIU Jian-jun;KAN He-ping(Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China)

机构地区：[1]南方医科大学南方医院肝胆外科,510515

出　　处：《现代消化及介入诊疗》2016年第2期190-193,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省自然科学基金(S2012020010942)

摘　　要：目的探讨原发性肝癌(HCC)患者T细胞免疫功能变化及其与外周血循环肿瘤细胞(CTCs)、肿瘤总体积(TTV)及乙肝病毒(HBV-DNA)定量的关系。方法收集45例HCC患者外周血,45例正常成年人外周血作为对照组。用流式细胞学技术测定CD3^+T细胞、CD4^+T细胞及CD4^+/CD8^+比值;采用益善生物技术公司的"免疫去除结合纳米过滤法"Can Patrol TM行CTCs检测。收集患者肿瘤最大直径及乙肝病毒定量(HBV-DNA)等临床病理参数。将HCC组患者依据CD4^+/CD8^+平均值分成高、低两组,比较两组之间CTCs、TTV、HBV-DNA定量的差别。结果 HCC组CD3^+T细胞、CD4^+T细胞及CD4^+/CD8^+明显低于对照组(P<0.05),CD8^+T细胞值明显高于正常组(P<0.05)。高CD4^+/CD8^+组CTCs总数及间质型CTCs明显低于低CD4^+/CD8^+组(P<0.05),而两组上皮型CTCs及混合型CTCs无明显差异(P>0.05)。CD4^+/CD8^+比值与TTV呈正相关(P<0.05),与CD8^+T细胞百分比呈负相关(P<0.05)。不同HBV-DNA组之间,CD4^+/CD8^+没有统计学差异(P>0.05)。结论 HCC患者T细胞免疫功能明显降低。T细胞免疫功能与CTCs、TTV与有着密切关系:T细胞免疫功能越差,外周血中CTCs越多、TTV越大。Objective To investigate the changes of T cell immune function in patients with hepatocellular carcinoma (HCC)and its relationship with circulating tumor cells (CTCs), total tumor volume (TTV) and hepatitis B virus (HBV-DNA). Methods Peripheral blood of 45 patients with HCC was collected, and peripheral blood of 45 normal adults was taken as control. CD3+ T cells, CD4 + T cells and CD4+/CD8 +ratio were determined by flow cytometry. CTCs in the blood were detected by CanPatrol?. The maximum diameter of tumor,quantitative hepatitis B vims (HBV-DNA) and other clinical pathological parameters were collected. The HCC patients were divided into high level group and low level group according to the rate of CD4+/CD8 + ,CTCs, TTV and HBV-DNA level. Results Compared with the healthy control, the percentage of CD3+ T cells,CD4+ T cells and the rate of CD4+/CD8+ in HCC patients were significantly decreased^ < 0.05); CD8+ T cells were significantly higher than the normal group (P < 0.05). The total CTCs and mesenchymal CTCs in high CD4+/CD8+ group were significantly less than in the low CD4+/CD8+ group, but there was no significant difference between the two groups of epithelial type CTCs and mixed CTCs (P > 0.05). The CD4+/CD8+ ratio was positively correlated with TTV (P < 0.05), and negatively correlated with the percentage of CD8+T cells (P <0.05). Between different HBV-DNA groups, no statistically significant differences were found between the ratio of CD4+/CD8+(/) > 0.05). Conclusions The immune function of T cells in patients with HCC was disordered,and the immune function of T cells was significantly decreased. The immune function of T cell had a close relationship with CTCs and TTV in patients with HCC.

关 键 词：原发性肝癌 T淋巴细胞 循环肿瘤细胞 肿瘤总体积 乙型肝炎病毒 

分 类 号：R512.62[医药卫生—内科学]