原发性肝癌患者切除术前后Th1/Th2漂移的变化及与复发转移的相关性研究  

The Change of Th1/Th2 Drift before and after Resection and Its Correlation with Recurrence and Metastasis in Patients with Primary Liver Cancer

作　　者：夏云展[1] 李琼[2] 李荣振[1] 朱少功[1] 李晓彦[1] XIA Yunzhan;LI Qiong;LI Rongzhen(Department of General Surgery,Zhengzhou People’s Hospital,Zhengzhou City,He’nan Province 450003;不详)

机构地区：[1]郑州人民医院普通外科,河南省郑州市450003 [2]郑州人民医院神经内科,河南省郑州市450003

出　　处：《医学理论与实践》2021年第24期4231-4234,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨原发性肝癌患者切除术前后Th1/Th2漂移的变化及与复发转移的相关性研究。方法:选取在本院行肿瘤切除术的原发性肝癌患者86例作为研究组和同期在本院进行体检的健康者60例作为对照组。采用酶联免疫吸附法(ELISA)测定研究组术前及术后1周、对照组血清中的γ干扰素(IFN-γ)和白细胞介素-4(IL-4)水平;酶联免疫斑点实验(ELISPOT)法检测外周血Th1、Th2细胞比例,并计算Th1/Th2。Kaplan-Meier法分析患者无复发转移生存期,COX回归分析Th1/Th2漂移与肿瘤复发转移的关系。结果:与对照组相比,研究组术前及术后IFN-γ水平及Th1/Th2比例显著降低(P<0.05),IL-4水平显著升高(P<0.05);研究组术后IFN-γ水平及Th1/Th2比例高于术前(P<0.05),IL-4水平低于术前(P<0.05);TNM分期、术后IFN-γ水平、IL-4和Th1/Th2比例是患者复发转移的影响因素(P<0.05),其中TNM分期和术后Th1/Th2比例是患者复发转移的独立危险因素。结论:肝癌患者存在Th1/Th2漂移,手术矫正后的Th1/Th2漂移程度与患者的复发转移等预后有关。Objective:To investigate the changes of Th1/Th2 drift before and after resection operation and its correlation with recurrence and metastasis in patients with primary liver cancer.Methods:86 patients with primary liver cancer who underwent tumor resection in our hospital were selected as the study group and 60 healthy people who took medical examination during the same period were selected as the control group.The serum levels of interferonγ(IFN-γ)and interleukin-4(IL-4)were determined by enzyme-linked immunosorbent assay(ELISA)before and one week after operation in the study group and in the control group;the ratio of Th1 and Th2 cells in peripheral blood was detected by enzyme-linked immunodot assay(ELISPOT),and Th1/Th2 was calculated.Kaplan-Meier method was used to analyze the survival time free of recurrence and metastasis of patients,COX regression model was used to analyze the relationship between Th1/Th2 drift and tumor recurrence and metastasis.Results:Compared with the control group,IFN-γlevel and Th1/Th2 ratio in the study group were significantly decreased before and after surgery(P<0.05),while IL-4 level was significantly increased(P<0.05);The levels of IFN-γand Th1/Th2 ratio in the study group after operation were higher than those before operation(P<0.05),and the levels of IL-4 were lower than those before operation(P<0.05);TNM stage,postoperative IFN-γlevel,IL-4 and Th1/Th2 ratio were the influencing factors for recurrence and metastasis of patients(P<0.05),among which TNM stage and postoperative Th1/Th2 ratio were independent risk factors for recurrence and metastasis of patients.Conclusion:Patients with liver cancer have Th1/Th2 drift,and the degree of Th1/Th2 drift after surgical correction was related to the prognosis of patients with recurrence and metastasis.

关 键 词：原发性肝癌 TH1/TH2漂移 IFN-Γ IL-4 复发转移 

分 类 号：R735.7[医药卫生—肿瘤]