根治性肝叶切除术治疗肝细胞癌患者外周血自然杀伤细胞活力变化及其临床意义探讨  

Implications of peripheral blood natural killer cell percentages in patients with hepatocellular carcinoma after radical hepatectomy

作　　者：袁小兵[1] 陈慰慰[1] 刘小莉[2] 姜铭[3] 范向军[4] Yuan Xiaobing;Chen Weiwei;Liu Xiaoli(Department of General Surgery,People's Hospital,Rugao 226500,Jiangsu Province,China)

机构地区：[1]江苏省如皋市人民医院普通外科,226500 [2]江苏省如皋市人民医院肿瘤介入科,226500 [3]江苏省如皋市人民医院检验科,226500 [4]南通大学附属医院肝胆外科

出　　处：《实用肝脏病杂志》2023年第4期544-547,共4页Journal of Practical Hepatology

摘　　要：目的探讨肝细胞癌(HCC)患者根治性肝叶切除术后外周血自然杀伤(NK)细胞活性变化及其临床意义。方法2019年5月~2021年5月我院收治的127例HCC患者,所有患者均接受根治性肝叶切除术治疗,随访2年。使用流式细胞仪检测外周血NK细胞百分比。进行影像学检查,将复发肿瘤分为Ⅰ期、Ⅱ期和Ⅲ期。结果术后,127例HCC患者外周血CD3^(-)CD56^(+)和CD3^(-)CD16^(+)CD56^(+)细胞百分比分别为(27.3±1.6)%和(16.3±1.4)%,均显著高于术前【分别为(16.4±1.4)%和(12.5±1.5)%,P<0.05】;术后随访发现肿瘤复发53例,肿瘤复发组外周血CD3^(-)CD56^(+)、CD3^(-)CD16^(+)CD56^(+)和D3^(-)CD161^(+)NK细胞百分比分别为(21.4±2.3)%、(14.8±1.5)%和(19.4±2.6)%,均显著低于未复发患者【分别为(25.4±2.6)%、(17.1±1.6)%和(22.6±2.8)%,P<0.05】;15例Ⅲ期复发肿瘤患者外周血CD3^(-)CD56^(+)、CD3^(-)CD16^(+)CD56^(+)和D3^(-)CD161^(+)NK细胞百分比分别为(15.3±1.6)%、(13.2±1.5)%和(17.3±1.2)%,显著低于21例Ⅱ期患者【分别为(20.2±1.4)%、(16.7±1.5)%和(20.4±2.5)%,P<0.05】或17例Ⅰ期患者【分别为(23.4±2.5)%、(17.1±1.7)%和(21.4±2.4)%,P<0.05】。结论HCC患者存在细胞免疫功能下降,在根治性肝叶切除术后患者自然杀伤细胞百分比上升,可能对防止肿瘤复发起一定的作用,值得进一步研究。Objective The aim of this study was to investigate the changes of peripheral blood natural killer(NK)cell percentages in patients with hepatocellular carcinoma(HCC)after radical hepatectomy.Methods A total of 127 patients with HCC were admitted to our hospital between May 2019 and May 2021,and all underwent radical hepatectomy.All the patients with HCC were followed-up for 24 months.The peripheral blood NK cell percentages were detected by flow cytometry.Based on the imaging,the recurrent tumors were divided into stage Ⅰ,stage Ⅱ and stage Ⅲ.Results Post-operationally,the percentages of peripheral blood CD3^(-)CD56^(+)and CD3^(-)CD16^(+)CD56^(+)cells in 127 patients with HCC were(27.3±1.6)% and(16.3±1.4)%,both significantly higher than[(16.4±1.4)%and(12.5±1.5)%,P<0.05]before operation;the imaging showed the recurrent tumors in 53 cases during the two-year follow-up,and the percentages of peripheral blood CD3^(-)CD56^(+),CD3^(-)CD16^(+)CD56^(+)and D3^(-)CD161^(+)NK cells in patients with recurrent tumors were(21.4±2.3)%,(14.8±1.5)%and(19.4±2.6)%,all significantly lower than[(25.4±2.6)%,(17.1±1.6)% and(22.6±2.8)%,respectively,P<0.05]in patients without recurrent tumors;the percentages of peripheral blood CD3^(-)CD56^(+),CD3^(-)CD16^(+)CD56^(+)and D3^(-)CD161^(+)NK cells in 15 patients with stage Ⅲ recurrent tumors were(15.3±1.6)%,(13.2±1.5)%and(17.3±1.2)%,all significantly lower than[(20.2±1.4)%,(16.7±1.5)%and(20.4±2.5)%,respectively,P<0.05]in 21 patients with stage Ⅱ or[(23.4±2.5)%,(17.1±1.7)% and(21.4±2.4)%,respectively,P<0.05]in 17 patients with stage Ⅰ recurrent tumors.Conclusions The patients with HCC have their cellular immune function deficiency,and the percentages of peripheral blood CD3^(-)CD56^(+),CD3^(-)CD16^(+)CD56^(+)and CD3^(-)CD161^(+)NK cells increase post-operationally,which might be helpful in preventing tumor recurrence.

关 键 词：肝细胞癌 根治性肝叶切除术 自然杀伤细胞 肿瘤复发 治疗 

分 类 号：R735.7[医药卫生—肿瘤]