肝癌切除术对肝癌患者外周血CD4^+CD25^+T调节细胞的影响

Effect of liver resection on regulatory CD4^+CD25^+T lymphocytes in peripheral blood of patients with hepatocellular carcinoma

目的:探讨肝癌切除术对肝癌患者外周血CD4+CD25+T调节细胞(Treg)的影响及临床意义。方法:42例原发性肝癌患者均行肝癌切除术,采用流式细胞术检测患者手术前及术后1个月外周血中Treg占单个核细胞(PBM)的比例,同样的方法检测肝癌组织和正常肝组织中Treg占单个核细胞的比例;采用ELISA检测肝癌组织和正常肝组织中转化生长因子-β(TGF-β),白介素-10(IL-10)的水平。结果:肝癌患者外周血及肝癌组织中Treg比例明显高于对照组(13.98±3.03)%vs(8.23±2.15)%,(17.74±4.12)%vs(6.98±2.36)%,P均<0.05,且Ⅲ～Ⅳ期患者外周血中Treg比例显著高于Ⅰ～Ⅱ期患者。肝癌切除术后1个月外周血Treg较术前明显减少(13.98±3.03)%vs(9.87±2.78)%,P<0.05。肿瘤组织中TGF-β、IL-10的水平明显高于正常肝组织(P<0.05)。结论:肝癌患者外周血Treg水平明显升高,且与TNM分期呈正相关。肝癌切除术能明显降低外周血Treg比例,这可能与手术切除肿瘤微环境中高水平Treg、TGF-β、IL-10有关。

Objective：To investigate the effect of liver resection on regulatory CD4^＋CD25^＋T lymphocytes （Treg） in peripheral blood and its clinic significance in for patients with hepatocellular carcinoma（HCC）. Methods：Flow eytometer was used to analyze the percent of Treg in peripheral blood mononudear cell before and after surgery,and the ratio of Treg to PBM in tumor tissue and normal liver tissue,enzyme-linked immunosorbent assay （ELISA） was used to detect the level of TGF-β,IL-10 in tumor tissue and normal liver tissue. Results：The percentage of Treg in PBM and tumor tissue of HCC patients were （13.98 ± 3.03）%, （17.74 ± 4.12）%,respectively, both were higher than those in the normal group,and the percentage of Treg in phase Ⅲ-Ⅳ patients was higher than that in phase Ⅰ -Ⅱ （P 〈 0.05）. One month after liver resection,the Treg significantly reduced in the PBM compared before operation （9.87±2.78）% （P 〈 0.05）. TGF-β and IL-10 in tumor tissue were significantly higher than those in normal liver tissue. Conclusion：The level of Treg in patients with HCC significantly increased,which was positive correlated with TNM classification. Liver resection can significantly reduce the proportion of Treg,for which may be related with that the removed tumor micro-environment has high level of Treg,TGF-β and IL-10.