慢性丙型肝炎、肝硬化、肝癌患者血清IL-17、IL-6和维生素D水平变化及其临床意义

Clinical significance of changes on serum levels of IL-17,IL-6 and vitamin D in patients with chronic hepatitis C,liver cirrhosis and hepatocellular carcinoma

目的探讨慢性丙型肝炎、丙肝肝硬化、丙肝相关肝癌患者血清IL-17、IL-6和维生素D[25-OH-D和1,25(OH)2D]水平的变化及其临床意义。方法酶联免疫法(ELISA)测定54例慢性丙型肝炎、47例丙肝肝硬化和32例丙肝相关肝癌患者的血清IL-17、IL-6和维生素D水平,并检测患者HCV-RNA滴度、AFP水平,并与50名健康对照者比较。结果与对照组相比,各组患者的血清IL-17、IL-6、HCV-RNA滴度和AFP水平显著增加,而维生素D水平显著降低;三组患者相比,血清IL-17、IL-6、HCV-RNA滴度和AFP水平随着病情的发展逐渐升高(肝癌组>肝硬化组>慢性丙型肝炎组),而维生素D水平随着病情的发展逐渐降低(肝癌组<肝硬化组<慢性丙型肝炎组);IL-17与HCV-RNA滴度、AFP和IL-6呈明显正相关,而与维生素D呈明显负相关,IL-6也与HCVRNA滴度、AFP呈明显正相关,而与维生素D呈明显负相关。结论血清IL-17、IL-6和维生素D可能与HCV活跃程度有关,并在HCV感染后引起肝脏损伤、肝硬化、肝癌的发生发展过程中起重要作用。同时,IL-17、IL-6和维生素D的检测可能作为肝脏损伤程度新的标志物及AFP等经典标志物在肝癌诊断中的补充。

Objective To explore the significance of changes on serum levels of interleukin-17 （IL-17） , interleu- kin-6 （IL-6） and vitamin D in patients with chronic hepatitis C, HCV-related liver cirrhosis and HCV-related hepatocel- lular carcinoma. Methods Peripheral blood were collected from patients with chronic hepatitis C （n = 54） , HCV-re- lated liver cirrhosis （ n = 47）, HCV-related hepatocellular carcinoma （ n = 32） and healthy individuals （ n = 50）. Serum IL-17, IL-6 and vitamin D concentrations were detected by ELISA. In addition, serum HCV-RNA titer and AFP levels were detected. Results Compared with control group, the concentration of IL-17, IL-6, HCV-RNA titer and AFP were increased, but the concentration of vitamin D was decreased obviously. Among the patients, the levels of IL-17, IL-6, HCV-RNA titer and AFP were increased gradually with the development of disease, but the vitamin D level was de- creased. Correlation analysis of data proclaimed that level of IL-17 correlated positively with levels of IL-6, HCV-RNA titer and AFP, but correlated negatively with levels of vitamin D. And serum IL-6 levels followed a similar pattern. Con- clusion Serum IL-17, IL-6 and vitamin D are related to chronic hepatitis activity. The changes of serum levels of IL- l7, IL-6 and vitamin D may play certain roles in occurrence and development of liver damage, liver cirrhosis and hepa- tocellular carcinoma. Meanwhile, the detection of IL-17, IL-6 and vitamin D may be as a new marker for liver damage degree and AFP added such classic markers in the diagnosis of hepatocellular carcinoma.