香菇多糖对肝癌患者化疗栓塞前后T淋巴细胞亚群及IL-12、sIL-2R的影响及临床意义

Effect and clinical significance of TACE combined with Lentinan on T-lymphocyte subsets、IL-12 and sIL-2R in patients with hepatic cancer

目的探讨肝癌患者免疫功能的状态及香菇多糖(Lentinan,LNT)对肝癌经导管行肝动脉化疗栓塞术(transcatheter arterial embolization,TACE)后T淋巴细胞亚群及IL-12、sIL-2R的影响及临床意义。方法40例原发性肝癌患者随机分为单纯TACE组和TACE联合LNT组,并设正常对照组。采用流式细胞术检测TACE前1天及TACE后两周患者外周血CD4+T细胞,CD8+T细胞,CD4+/CD8+比值。同时采用Elisa(酶联免疫吸附试验)检测TACE前1天及TACE后四周患者外周血IL-12,sIL-2R水平。应用SAS8.2软件进行统计学分析。结果1.肝癌患者外周血CD4+T细胞数量减少,CD8+T细胞数量增加,CD4+/CD8+比值降低,IL-12水平降低,sIL-2R水平升高,与C组对照有统计学意义(P<0.05)。2.单纯TACE后患者外周血CD4+T细胞数量增加,CD8+T细胞数量减少,CD4+/CD8+比值升高,IL-12水平升高,sIL-2R水平降低,与TACE前对照有统计学意义(P<0.05)。TACE联合LNT组,各组数值变化更加明显,前对照有统计学意义(P<0.05)。3.TACE联合LNT组术后各组数值与单纯TACE后各组数值对照有统计学意义(P<0.05)。结论肝癌患者细胞免疫功能低下,单纯TACE治疗可使瘤体减小,免疫功能得到一定提高。香菇多糖可明显改善TACE的毒副作用,促进免疫功能重建,值得临床推广应用。

Objective：To explore the state of immune function and the influence of TACE combined with Lentinan,LNT on T-lymphocyte subsets、IL-12 and sIL-2R in patients with hepatic cancer.Methods： 40 patients of hepatic cancer were randomly divided into TACE group and TACE combined with LNT group namely.Healthy subjects were served as normal control group.Fresh peripheral bloods from subjects were collected at one day pre-TACE as well as two weeks（four weeks for IL-12 and sIL-2R） post-TACE.T-Lymphocyte subsets were detected by flow cytometry.IL-12 and sIL-2R were detected by Elisa.Statistical analyses were throughmethod of SAS 8.2 statistical analysis software.Results： 1.Numbers of CD4＋T cell、CD4＋/CD8＋ratio and IL-12 were significantly lower than those in normal controls（P0.05） in patients with hepatic cancer.Numbers of CD8＋T cell and sIL-2R were significantly higher than those in normal controls（P0.05） in patients with hepatic cancer.2.Two weeks（four weeks） afterTACE,numbers of CD4＋T cell、CD4＋/CD8＋ratio and IL-12 increased than those before TACE（P0.05） in patients of TACE group,numbers of CD8＋T cell and sIL-2R decreased than those before TACE（P0.05） in patients of TACE group.Every group＇s datas changed obviously in patients of TACE combined with LNT group（P0.05）.3.The comparison of patients between TACE combined with Lentinan group and TACE group,Level of CD4＋T cell、CD8＋T cell 、CD4＋/CD8＋ratio（two weeks after TACE） and IL-12、sIL-2R（four weeks after TACE） changed obviously（P0.05）.Conclusion： The immune function in patients with hepatic cancer is suppressed,TACE can make tumor smaller,immune function improved.LNT can significantly reduce toxic side effects of TACE,promote immune reconstitution.LNT is an idea,l safe,reliable and immune enhancer,worthy to be popularized.