肝癌患者血清铁含量及手术前后T淋巴细胞亚群变化

Changes of serum ferritin and T lymphocyte subsets before and after the surgery of patients with hepatocellular carcinoma

目的探讨肝癌患者血清铁(Fe)含量及手术前后T淋巴细胞亚群变化,揭示Fe含量与肝癌的关系及手术对患者免疫功能的影响。方法选取100例原发性肝癌患者(肝癌组)及50名门诊体检正常者(对照组),测定血清Fe、铁蛋白(Ferr)、转铁蛋白(TRF)含量,术前第2天及术后第3天、术后第7天、术后第14天T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+水平。结果肝癌组患者血清Fe、Ferr含量明显高于对照组,TRF含量低于对照组,两组相比,差异有统计学意义(P<0.05);肝癌组术前CD3+、CD4+、CD4+/CD8+水平低于对照组,CD8+水平高于对照组,两组相比,差异有统计学意义(P<0.05);肝癌组术后3 d、7 d CD3+、CD4+、CD8+、CD4+/CD8+水平明显低于术前,差异有统计学意义(P<0.05);术后14 d与术前相比,水平接近,差异无统计学意义(P>0.05)。结论肝癌患者Fe、Ferr含量较正常人群明显增高,TRF、细胞免疫较正常人群明显下降,在术后细胞免疫被抑制状态更为严重,后随着时间延长有所恢复,因而对肝癌患者应进行血清Fe、Ferr、TRF含量监测及术后免疫干预治疗。

Objective To investigate the changes of serum ferritin and T lymphocyte subsets before and after the surgery of patients with hepatocellular carcinoma （HCC）,and to reveal the relationship between ferritin concentration and HCC.Methods One hundred cases of HCC （HCC group） and 50 cases of normal people （control group） were selected.Serum Fe,ferritin （Ferr）,transferrin （TRF） content and CD3 ^＋,CD4^＋,CD8 ^＋,CD4^＋/CD8 ^＋ levels before and after the surgery were observed.Results In HCC group,serum Fe,Ferr were significantly higher than those in the control group,TRF content was lower than that in the control group,the difference was statistically significant （P 〈0.05）; before the surgery,CD3 ^＋,CD4^＋,CD4^＋/CD8^＋ levels in HCC group were lower than those in the control group,CD8 ^＋ level was higher （P 〈0.05） ; after the surgery 3 d and 7 d,CD3 ^＋,CD4^＋,CD8 ^＋,CD4^＋/CD8 ^＋ levels in the HCC group were lower than preoperative （P 〈 0.05）,but there was not statistically significant between preoperation and 14-day after the operation （P 〉 0.05）.Conclusion Fe,Ferr contents of HCC patients are significantly higher than the normal population,TRF,cellular immunity are lower than the normal population.Suppressed cell-mediated immunity in the postoperative state is more serious,the latter has been restored with time,so we should monitor serum Fe,Ferr,TRF content of HCC patients,and give immune intervention.