动态监测肝癌手术患者血清sIL-2R的意义及其来源探讨  

Significance of dynamic monitoring of serum sIL-2R level and its origin in hepatocellular carcinoma patients undergoing surgery

作　　者：陆旭[1] 周闯[1] 叶健文[1] 董琳[2] 赵璐[3] 翟文龙[1] Lu Xu;Zhou Chuang;Ye Jianwen;Dong Lin;Zhao Lu;Zhai Wenlong(Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Blood Purification Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Physical Examination Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肝胆胰外科,450052 [2]郑州大学第一附属医院血液净化中心,450052 [3]郑州大学第一附属医院体检中心,450052

出　　处：《中华肝脏外科手术学电子杂志》2020年第3期264-268,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：河南省高校科技创新人才支持项目(14HASTIT030)。

摘　　要：目的探讨肝细胞癌(肝癌)手术患者血清中可溶性白细胞介素2受体(sIL-2R)变化规律,并初步探讨其来源及临床意义。方法回顾性分析2013年9月至2014年1月在郑州大学第一附属医院接受手术治疗的45例肝癌患者临床资料。其中男40例,女5例;年龄36~75岁,中位年龄53岁。选取同期6例肝硬化患者为对照。患者均签署知情同意书,符合医学伦理学规定。采用ELISA法测定患者血清sIL-2R含量;根据血清sIL-2R含量中位数,将患者分为sIL-2R高水平组和sIL-2R低水平组,观察术前sIL-2R水平与临床病理学参数、生存预后、肿瘤复发的关系。采用免疫组化、免疫荧光染色检测肝癌组织sIL-2R的表达情况。两组血清sIL-2R水平比较采用t检验,sIL-2R水平与临床病理学参数关系分析采用χ^2检验。生存分析采用Kaplan-Meier法及Log-rank检验。结果肝癌患者血清sIL-2R为(142±16)pmol/L,明显高于肝硬化患者的(61±7)pmol/L(t=2.488,P<0.05)。术前sIL-2R水平与HBsAg、BCLC分期密切相关(χ^2=7.753,4.465;P<0.05)。sIL-2R术后1个月内明显降低,肿瘤复发时再次升高,复发肿瘤再切除后可再次下降。sIL-2R高水平组患者中位生存时间为25个月,sIL-2R较低组为33个月,两组生存率差异有统计学意义(χ^2=3.945,P<0.05)。sIL-2R高水平组手术患者3年复发率为78.2%,明显高于sIL-2R低水平组的44.6%(χ^2=5.165,P<0.05)。免疫组化、免疫荧光染色显示白细胞介素2受体α(IL-2Rα)主要定位于肝星状细胞。结论肝癌患者血清sIL-2R含量明显升高,其与肿瘤复发和患者生存有关,sIL-2R来源于肝星状细胞,其在肝癌免疫疫调控中起一定作用。Objective To investigate the changes of serum soluble interleukin-2 receptor(sIL-2R)level in hepatocellular carcinoma(HCC)patients undergoing surgery,and to explore its origin and clinical significance.Methods Clinical data of 45 HCC patients who received surgical treatments from September 2013 to January 2014 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Among them,40 patients were male and 5 female,aged 36-75 years with a median age of 53 years.6 patients with liver cirrhosis in the same period were selected as controls.The informed consents of all patients were obtained and the local ethical committee approval was received.The serum sIL-2R level was measured by ELISA.According to the median level of serum sIL-2R,all patients were divided into the high-and low-sIL-2R groups.The relationship between preoperative sIL-2R level and clinicopathological parameters,survival prognosis and tumor recurrence was observed.The expression of sIL-2R in liver cancer tissues was analyzed by immunohistochemistry and immunofluorescence staining.The serum sIL-2R level between 2 groups was statistically compared by t test,and the correlation between sIL-2R level and clinicopathological parameters was analyzed by Chi-square test.Survival analysis was conducted by Kaplan-Meier survival analysis and Log-rank test.Results The serum sIL-2R level in HCC patients was(142±16)pmol/L,significantly higher than(61±7)pmol/L in patients with liver cirrhosis(t=2.488,P<0.05).The preoperative sIL-2R level was closely related to HBsAg and BCLC staging(χ^2=7.753,4.465;P<0.05).The serum sIL-2R level was significantly decreased within postoperative 1 month,and increased when the tumors recurred,and declined after the resection of recurrent tumors.The median survival of patients in high-sIL-2R group was 25 months,and 33 months in low-sIL-2R group,where significant difference was observed(χ^2=3.945,P<0.05).The 3-year recurrence rate in the high-sIL-2R group was 78.2%,significantly higher than 44.6%in low-sIL-2

关 键 词：癌 肝细胞 受体 白细胞介素 肿瘤复发 预后 

分 类 号：R735.7[医药卫生—肿瘤]