摘要
目的探讨细胞因子和调节性T细胞(regulatory T cell,Treg细胞)在肝癌患者外周血中的表达及其临床应用价值。方法回顾性选取2019年7月至2021年7月宁波大学附属李惠利医院收治的肝病患者107例,其中肝癌73例,慢性肝炎34例;另选取同期健康体检者40例作为对照组。采用流式细胞术检测3组研究对象的外周血细胞因子和Treg细胞表达水平,同时对肝癌患者根据TNM分期、病理分期、MVI分期、CTP评分是否合并乙肝、是否合并肝硬化6个影响因素进行亚组设置,对结果进行统计学分析。结果肝癌患者白细胞介素(interleukin,IL)-2、IL-6、IL-10和Treg细胞表达水平较慢性肝炎患者和健康体检者均显著升高,差异均有统计学意义(P<0.05)。晚期肝癌患者IL-6和IL-10水平显著高于早期患者(Hc=373.500、484.500,P=0.001、0.046),CTP评分B级肝癌患者IL-6水平显著高于A级患者(Hc=191.000,P=0.021),肝癌合并乙肝者γ干扰素(interferon-γ,IFN-γ)水平显著降低(Hc=367.000,P=0.020),MVI为M1+M2期患者IL-2、IL-6、IL-17A水平临界高于M0期患者(Hc=94.000、97.000、96.000,P=0.062、0.079、0.072),CTP评分B级肝癌患者IL-10、IFN-γ、肿瘤坏死因子α水平临界高于A级患者(Hc=224.500、220.500、227.000,P=0.072、0.063、0.079)。肝癌患者根治术后IL-6水平临界升高(Z=-1.912,P=0.056),而Treg细胞水平临界降低(t=1.920,P=0.069)。结论肝癌患者IL-6、IL-10和Treg细胞表达水平上调,且多种细胞因子受肝癌分期、CTP评分、是否合并乙肝感染、MVI分期及手术治疗等因素的影响。
Objective To investigate the expression and clinical value of cytokines and Treg cells in peripheral blood of patients with liver cancer.Methods A total of 107 patients with liver disease admitted to Li Huili Hospital Affi-liated to Ningbo University from July 2019 to July 2021 were selected,including 73 cases of liver cancer and 34 cases of chronic hepatitis,and 40 cases of healthy subjects during the same period were selected as the control group.The expression levels of cytokines and Treg cells in all subjects were detected by flow cytometry,at the same time,ac-cording to TNM stage,pathological stage,MVI stage,CTP score,whether combined with hepatitis B and whether combined with cirrhosis,the patients with liver cancer were divided into subgroups,and the results were statistically analyzed.Results The expression levels of interleukin(IL)-2,IL-6,IL-10 and Treg cells in patients with liver cancer were significantly higher than those in patients with chronic hepatitis and healthy subjects,the differences were statis-tically significant(P<0.05).IL-6 and IL-10 levels in patients with advanced liver cancer were significantly higher than those in early stage(Hc=373.500,484.500,P=0.001,0.046).IL-6 in liver cancer patients with CTP grade B was higher than that of patients with CTP Grade A(Hc=191.000,P=0.021),and IFN-γlevel in liver cancer with hepatitis B was much lower than that without hepatitis B(Hc=367.000,P=0.020).The levels of IL-2,IL-6 and IL-17 A in pa-tients with MVI at M1+M2 stage were significantly higher than those in patients with M0 stage(Hc=94.000,97.000,96.000;P=0.062,0.079,0.072).The levels of IL-10,IFN-γ,TNF-αin liver cancer with CTP grade B was marginally higher than those with Grade A(Hc=224.500,220.500,227.000;P=0.072,0.063,0.079).The level of IL-6 marginally increased(Z=-1.912,P=0.056)and the level of Treg cells marginally decreased(t=1.920,P=0.069)after radical re-section of liver cancer.Conclusion The expression levels of IL-6,IL-10 and Treg cells in patients with liver cancer were up-regulated,and a variety of cytokines were affected by liver cancer stage,CTP score,whether combined with hepatitis B infection,MVI stage and surgical treatment.
作者
章丽巧
胡耀仁
高国生
ZHANG Liqiao;HU Yaoren;GAO Guosheng(Department of Laboratory,Li Huili Hospital Affiliated to Ningbo University,Zhejiang Ningbo 315040,China;Department of Liver Diseases,Ningbo HuaMei Hospital,University of Chinese Academy of Sciences,Zhejiang Ningbo 315010,China;Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province,Zhejiang Ningbo 315010,China)
出处
《中国现代医生》
2022年第21期7-11,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY271)
宁波市公益类科技计划项目(2019C50035,202002N3156)。
关键词
肝癌
细胞因子
TREG细胞
肝癌根治术
Liver cancer
Cytokine
Treg cells
Radical resection of liver cancer
