外周血CD8^(+)T淋巴细胞低表达与肝细胞肝癌的临床相关性分析  

Clinical correlation Analysis of D8^(+)T lymphocytes and Hepatocellular Carcinoma

作　　者：张彬 万得晨 陈忠彪 孙浩然 周大臣[1] 侯辉[1] ZHANG Bin;WAN De-chen;CHEN Zhong biao(Department of General Surgery,the Second Hospital of Anhui Medical University,Hefei,Anhui)

机构地区：[1]安徽医科大学第二附属医院肝胆外科,合肥巴230600

出　　处：《肝胆外科杂志》2024年第4期283-288,共6页Journal of Hepatobiliary Surgery

基　　金：安徽省科技厅临床医学研究转化专项(编号:202204295107020029);安徽医科大学校基金(编号:2022xkj176)。

摘　　要：1目的分析肝细胞肝癌(HCC)患者外周血中CD8^(+)T淋巴细胞低表达的危险因素并构建临床预测模型。方法收集2018年8月至2021年12月安徽医科大学第二附属医院收治143例肝细胞肝癌患者为研究对象,应用流式细胞仪检测患者外周血淋巴细胞,对比正常人群外周血CD8^(+)T淋巴细胞计数范围将143例患者分为CD8^(+)T淋巴细胞低表达组及CD8^(+)T淋巴细胞正常表达组,采用单因素分析分析肝癌患者外周血CD8^(+)T淋巴细胞表达下降的危险因素,多因素logistic二元回归分析D8^(+)T淋巴细胞表达下调的危险因素。应用R4.2.1建立Nomogram预测模型图,绘制ROC曲线计算一致性指数,绘制校准曲线内部验证进行决策曲线分析(DCA)并进行比较。结果143例HCC患者45例(31.5%)患者CD8^(+)T细胞表达下降,98例(68.5%)患者CD8^(+)T细胞表达正常或增高。两组患者在甲胎蛋白(AFP)、血小板(PLT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)、凝血酶原时间(PT)、国际标准值(INR)、K值、R15有显著性统计学差异,P<0.05。多因素分析发现AFP>20ng/L,(0R=0.22,95%CI:0.06-0.86,P<0.05)、Ks值,(0R=0.22,95%CI:0.06-0.86,P<0.05)、肝硬化是肝细胞肝癌患者D8^(+)T细胞低表达的独立危险因素。Objective To analyze the risk factors of low expression of D8^(+)T lymphocytes in peripheral blood of patients with hepatocellular carcinoma(HCC).Methods 143 patients with HCC treated in the Second Affiliated Hospital of Anhui Medical University from August 2018 to December 2021 were selected as the research object.The peripheral blood lymphocytes of patients were detected by flow cytometry,and 143 patients were divided into D8^(+)T lymphocyte low expression group and D8^(+)T lymphocyte normal expression group according to the counting range of peripheral blood D8^(+)T lymphocytes in normal population.The risk factors of D8^(+)T lymphocyte expression in peripheral blood of HCC patients were analyzed by single factor analysis.Use R4.2.1 to establish Nomogram prediction model diagram.Results The expression of D8^(+)T cells decreased in 45(31.5%)of the 143 HCC patients,while the expression of D8^(+)T cells was normal or increased in 98(68.5%)patients.There were significant statistical differences in alphafetoprotein(AFP),platelet(PLT),aspartate aminotransferase(AST),total bilirubin(TBil),albumin(ALB),,prothrombin time(PT),international standard value(INR),K value and R15 between the two groups,P<0.05.There was no significant difference in HBsAg,HBV-DNA,tumor number,tumor diameter,cirrhosis and portal vein tumor thrombus(P>0.05).Logistic regression analysis indicated.

关 键 词：肝细胞癌 免疫微环境 CD8^(+)T细胞 危险因素 列线图 

分 类 号：R735.7[医药卫生—肿瘤]