肝癌患者TACE治疗前后血清免疫炎症相关因子的变化及意义  

Changes and significance of serum immune and inflammation related factors before and after TACE in patients with hepatocellular carcinoma

作　　者：闫伟 戴雪娥 郉晓宇 陈韭铭 YAN Wei;DAI Xue-e;XING Xiao-yu;CHEN Jiu-ming(Clinical Laboratory,Naval Specialty Medical Center,Shanghai 200052,China;Clinical Laboratory,North Campus,Shanghai Jiaotong University Affiliated Hospital,Shanghai 201800,China)

机构地区：[1]上海海军特色医学中心检验科,上海200052 [2]上海交通大学医学院附属瑞金医院北部院区检验科,上海201800

出　　处：《中国肿瘤临床与康复》2022年第3期269-273,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的 探讨肝细胞癌(HCC)患者经导管动脉化疗栓塞术(TACE)治疗前后血清免疫炎症相关因子与患者近期疗效的关系。方法 选取2019年1月至2021年3月海军特色医学中心及上海交通大学医学院附属瑞金医院收治的采用TACE治疗的100例HCC患者为研究对象。根据治疗1~3个月后治疗效果将HCC患者分为预后良好组和预后不良组。采用酶联免疫吸附(ELISA)法检测血清中干扰素-γ(IFN-γ)、肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-1β(IL-1β)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和白细胞介素-17(IL-17)水平,并据试剂盒说明判断患者各因子表达阴阳性,分析IL-5、IL-6和IL-8与HCC患者临床病理特征关系。采用多因素Logistic回归分析影响HCC患者TACE治疗后发生预后不良的独立危险因素。结果 与HCC治疗前相比,HCC治疗后血清IL-5、IL-6和IL-8水平阳性比例较低,差异均有统计学意义(均P<0.05)。HCC患者治疗后血清IL-5、IL-6和IL-8表达与HCC的TNM分级和术前甲胎蛋白(AFP)水平具有相关性,差异均有统计学意义(均P<0.05)。与预后良好组相比,预后不良组IL-5阳性比例、IL-6阳性比例和IL-8阳性比例较高,差异均有统计学意义(均P<0.05)。Logistic回归分析显示,TNF-α、IL-6和IL-8是HCC患者TACE治疗后预后不良的危险因素,差异均有统计学意义(均P<0.05)。结论 TACE术后HCC患者血清IL-5、IL-6和IL-8可提示TACE术后HCC患者近期疗效。Objective To investigate the relationship between serum immune and inflammation related factors before and after transcatheter arterial chemoembolization(TACE) and the short-term efficacy in patients with hepatocellular carcinoma(HCC). Methods One hundred HCC patients who underwent TACE treatment were selected at Shanghai Jiaotong University Affiliated Hospital from January 2019 to March 2021. According to the treatment efficacy over 1 to 3 months of treatment, these patients were divided into a good prognosis group and a poor prognosis group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of serum interferon-γ(IFN-γ), tumor necrosis factor-ɑ(TNF-ɑ), interleukin-1β(IL-1β), interleukin-4(IL-4), interleukin-5(IL-5), interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10), and interleukin-17(IL-17). According to the kit instructions, the positive and negative expression of each factor was identified, and the relationship between IL-5, IL-6, IL-8 and clinicopathological characteristics of HCC patients were analyzed. Multivariate Logistic regression was used to analyze the independent risk factors affecting the poor prognosis of HCC patients after TACE treatment. Results Compared with before HCC treatment, the positive rates of serum IL-5, IL-6 and IL-8 levels were lower after HCC treatment(all P<0.05). Serum IL-5, IL-6 and IL-8 expression of HCC patients was correlated with TNM grade of HCC and preoperative alpha fetoprotein(AFP) level after treatment(all P<0.05). Compared with the good prognosis group, the positive expression of IL-5, IL-6 and IL-8 were high in the poor prognosis group(all P<0.05). Logistic regression analysis showed that TNF-α, IL-6, and IL-8 were risk factors for poor prognosis of HCC patients after TACE treatment(all P<0.05). Conclusion Serum IL-5, IL-6 and IL-8 may indicate the short-term efficacy in HCC patients undergoing TACE.

关 键 词：肝细胞肿瘤 经导管动脉化疗栓塞术 免疫炎症相关因子 预后 

分 类 号：R735.7[医药卫生—肿瘤]