原发性肝癌患者肝切除术前、后免疫细胞表型分析

Analysis of the phenotypes of immunological cell in patients with Primary Liver Carcinoma pre- and post-hepatectomy

目的研究原发性肝癌(PrimaryLiverCarcinoma,PLC)患者肝切除术前、后免疫细胞表型的变化。方法采用直接免疫荧光标记,流量血细胞计数法(FlowCytometry,FCM)检测方法,动态观察120例PLC患者肝切除术前后外周血T淋巴细胞亚群、NK细胞和HLA鄄DR含量变化。结果肝切除术前肝功能Child鄄PughB级、OGTTL型和术前施行肝动脉栓塞化疗患者外周血CD8+T细胞含量明显低于正常人组,CD4+/CD8+比值则较高(P<0郾05)。全部肝癌患者肝切除术前、后CD3+CD4+T细胞和NK细胞(CD3-CD16+CD56+)含量无明显差异。术后第1天、第3天、第7天和第2周外周血淋巴细胞CD3+CD8+含量明显低于肝切除术前和术后第3周(P<0.01);而CD4+/CD8+比值则显著高于肝切除术前和术后第3周(P<0郾01)。结论PLC合并肝硬变肝储备功能不足、术前肝动脉栓塞化疗和肝切除术可导致机体细胞免疫功能低下,PLC患者肝切除术前行肝动脉栓塞化疗的价值有待深入研究。

Objective To investigate the changes of phenocytes of immunological cell in patients with primary liver carcinoma (PLC) pre- and post-hepatotectomy. Methods T lymophocytes subsets,NK cells and HLA-DR molecules in 120 cases with PLC were observed dynamically by using direct immunofluorescence staining and flow cytometry.Results A significant lower percentage of CD8+ T lymphocytes and higher ratio of CD4+/CD8+ in peripheral blood were found in PLC patients with liver function of Child-Pugh Grade B,and OGTT L pattern, as well as the patients with the treatment of hepatic arterial chemoembolization(HACE)preoperatively (compared to healthy control group respectively, P < 0?郾05). Percentage of CD3+CD4+ T cell and NK cell (CD3-CD16+CD56+) revealed no difference in 120 cases with PLC pre-and post-hepatectomy. During post-operation from day 1 to day 14, a significant lower percentage of CD3+CD8+ in peripheral blood of PLC patients was detected as compared to that detected pre-operation or on day 21 post-operation respectively (P< 0?郾01). Nevertheless, the ratio of CD4+/CD8+ was obviously higher than that pre and post hepatectomy 21th day.Conclusions Insufficient reserve of liver function,preoperative HACE and hepatectomy can result in a lower cellular immulogic function. Meanwhile, the value of preoperative HACE for PLC is worth further studying.