HBV相关原发性肝癌患者外周血T、NK、B细胞及胸腺功能特征

Changes in peripheral blood T, NK and B cells and thymus function in patients with HBVrelated primary liver cancer

目的:观察乙型肝炎相关原发性肝癌患者(hepatitis B virus-related primary liver cancer,H B V-P L C)发生和进展过程中外周血T、N K、B细胞数量的变化,并初步探讨T淋巴细胞减少与胸腺功能的联系.方法:收集在首都医科大学附属北京地坛医院住院的73例HBV-PLC患者,50例乙型肝炎肝硬化患者(liver cirrhosis,LC),37例慢性乙型肝炎(chronic hepatitis B,CHB)患者.收集3组患者一般资料和临床生化指标.采用流式方法检测3组患者外周血中CD3^+T淋巴细胞、CD4^+T、CD8^+T、CD3-CD16^+CD56^+NK、CD3-CD19^+B的分布情况,并检测了T淋巴细胞表面CD31、CD45RA分子的表达水平.结果:与CHB和LC患者相比,HBV-PLC患者外周血中性粒细胞升高,淋巴细胞减少(P<0.001);与CHB患者相比,HBV-PLC患者外周血NK细胞计数减少(P=0.011),T淋巴细胞、CD4^+T、C D8^+T、B细胞计数减少,纯真CD4^+和CD8^+T细胞表面CD31表达降低(P<0.001).在肝癌Child、Okuda、BCLC分期中晚期比早期淋巴细胞计数、T、CD4^+T、CD8^+T计数均降低(P<0.05).结论:随着肝癌的发生和进展,HBV-PLC患者外周血抗肿瘤免疫细胞减少,这种减少与胸腺迁出功能降低有关.

AIM：To explore changes in the distribution of peripheral blood T,NK and B cells and thymus function in the occurrence and progression of hepatitis B virus-related primary liver cancer（HBV-PLC）.METHODS：Clinical and laboratory data of73 HBV-PLV patients,50 liver cirrhosis（LC）patients and 37 chronic hepatitis B（CHB）patients were collected at Beijing Ditan Hospital,Capital Medical University.The distribution of CD3~＋ T,CD4~＋ T,CD8~＋ T,CD3-CD16~＋CD56~＋ NK,CD3-CD19~＋ B cells and the expression of CD31,CD45 RA on T cells were detected in peripheral blood of all patients by flow cytometry.RESULTS：Compared with CHB and LC patients,the percentage and absolute number of lymphocytes declined in HBV-PLC patients（P〈0.001）.Compared with LC patients,the numbers of T,CD4~＋ T,CD8~＋ T,B（P〈0.001）,and NK cells（P = 0.011） significantly decreased in HBV-PLC patients.With regard to ChildPugh,Okuda,and BCLC stages,the numbers of lymphocytes,T,CD4~＋ T,and CD8~＋ T cells were significantly lower in advanced stages than in early stages（P〈0.05）.CONCLUSION：The immune cells that have anti-tumor effects decrease in the peripheral blood of HBV-PLC patients,which may be due to the reduced thymus function.