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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 hepatocellular carcinoma (HCC) resection on CD4 + CD25 + T regulatory cells (Treg) in peripheral blood of patients with hepatocellular carcinoma and its clinical significance. Methods: Forty-two patients with primary liver cancer underwent hepatectomy. The proportion of Tregs to mononuclear cells (PBM) in peripheral blood was measured by flow cytometry before and one month after operation. The same method was used to detect the expression of HCC And the ratio of Treg to mononuclear cells in normal liver tissue. The levels of TGF-β, IL-10 in hepatocellular carcinoma and normal liver tissues were detected by ELISA. Results: The proportion of Treg in peripheral blood and hepatocellular carcinoma was significantly higher than that in control group (13.98 ± 3.03)% vs (8.23 ± 2.15)%, (17.74 ± 4.12)% vs (6.98 ± 2.36)%, P <0.05, And the proportion of Treg in peripheral blood of stage Ⅲ ~ Ⅳ patients was significantly higher than that of stage Ⅰ ~ Ⅱ patients. Tregs in peripheral blood decreased significantly (13.98 ± 3.03)% vs (9.87 ± 2.78)% at 1 month after hepatectomy, P <0.05. The levels of TGF-β and IL-10 in tumor tissue were significantly higher than those in normal liver tissue (P <0.05). Conclusion: The level of Treg in peripheral blood of patients with hepatocellular carcinoma was significantly increased, which was positively correlated with TNM stage. HCC resection can significantly reduce the proportion of peripheral blood Treg, which may be related to the surgical removal of high levels of tumor microenvironment Treg, TGF-β, IL-10.