病毒性肝炎和原发性肝癌患者血清IL2相关指标的意义

Significance of IL 2 and related indexes in patients with hepatitis and hepatocellular carcinoma *

目的研究病毒性肝炎和原发性肝癌（ＨＣＣ）患者ＩＬ２，ｓＩＬ２Ｒ，ＩＬ６，Ｔ细胞亚群的变化意义．方法采用双抗体夹心ＥＬＩＳＡ法，ＡＢＳＥＬＩＳＡ法和红细胞花环实验对９４例各型病毒性肝炎和１０例ＨＣＣ进行了ＩＬ２，ＩＬ６，ｓＩＬ２Ｒ和Ｔ细胞亚群的测定，并与６６例健康献血员进行了对照．结果急性肝炎（ＡＨ）ＩＬ２水平增高，恢复期下降；而慢性肝炎（中重）、肝炎肝硬变（ＬＣ）、ＨＣＣ患者血清ＩＬ２水平明显低于慢性肝炎（轻）（Ｆ＝２０２６，Ｐ＜００１）和正常对照（ＮＣ）组．在乙型肝炎、ＨＢＶＤＮＡ阳性组的ＩＬ２水平显著低于ＨＢＶＤＮＡ阴性组．在ＣＨ，ＬＣ，ＨＣＣ组，ＩＬ２与ＣＤ＋４／ＣＤ＋８比值正相关，在各型肝炎和ＨＣＣＩＬ２与ｓＩＬ２Ｒ，ＩＬ６无相关关系．ＨＣＣ组的ＩＬ６水平高出正常１０倍以上，较各型肝炎组也明显升高（Ｆ＝３００７，Ｐ＜００１）．结论在病毒性肝炎和ＨＣＣ存在免疫功能紊乱和低下，淋巴因子网络失衡，这与肝炎和ＨＣＣ的病理生理机制有关，也为临床ＩＬ２治疗提供了理论依据．ＩＬ６的极显著增高有助于ＨＣＣ的诊断．

AIM To study the changes and clinical significance of IL2 , sIL2R , IL6 and T cell subsets in patients with hepatitis and hepatocellular carcinoma (HCC). METHODS IL2 , sIL2R , IL6 and T cell subsets were detected by double sandwich ELISA, avidin biotin system ELISA, erythrocyte cycle test respectively in 94 patients with hepatitis, 10 patients with HCC and 66 healthy persons. RESULTS The IL2 levels were increased in acute phase and decreased in convalescent phase in acute hepatitis; they were much lower in patients with chronic moderate/severe hepatitis, liver cirrhosis (LC) and HCC than chronic mild hepatitis ( F =20 26, P <0 01) and normal controls (NC). Compared with HBV DNA negative patients, the IL2 levels in patients with hepatitis B with positive HBV DNA were decreased. There was a positive correlation between IL2 and CD + 4/CD + 8 ratio, but was not between IL2 and IL6 , sIL2R in viral hepatitis and HCC. IL6 levels in HCC were 10 fold higher than that in NC, and also much higher than that in any type of hepatitis ( F =30 07, P <0 01). CONCLUSION Lymphokine network is abnormal in patients with hepatitis and HCC. It may be important in the pathophysiology and give the rationales for use of IL2 treatment in CH, LC and HCC. The remarkably higher level of IL6 is helpful for diagnosing HCC.