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目的 进一步了解肝癌患者的异常免疫状态,探讨血清、腹水中可溶性肿瘤坏死因子受体-p55（sTNFR-p55）检测的临床意义。方法 以双单抗夹心酶免疫吸附法检测了25例肝癌患者和25例肝硬化患者的血清、腹水中血清sTNFR-p55水平并以正常人为对照。结果肝癌病人血清sTNFR-p55浓度[（0.74±0.50）ng/ml]显著高于正常人[（0.37±0.03）ng/ml]和肝硬化患者和[（0.35±0.02）ng/ml],P<0.01。肝癌病人腹水sTNFR-p55浓度[（1.11±1.25）ng/ml]亦显著高于肝硬化患者[（0.33±0.03）ng/ml],P<0.01。肝癌、肝硬化患者血清与腹水的sTNFR-p55水平显著相关。肝癌患者血清sTNFR-p55水平与外周血TBil和AFP呈正相关（r=0.524,P=0.01和r=0.234,P=0.03）。结论 sTNFR-p55的检测对反映肝癌患者的异常免疫状态和肿瘤诊断具有实用价值。
Objective To further understand the abnormal immune status in patients with hepatocellular carcinoma and to investigate the clinical significance of the detection of soluble tumor necrosis factor receptor-p55 (sTNFR-p55) in serum and ascites. Methods Serum ascites and serum levels of sTNFR-p55 were detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) in 25 patients with liver cancer and 25 patients with cirrhosis and normal controls. Results Serum levels of sTNFR-p55 in hepatocellular carcinoma patients were significantly higher than those in normal controls [(0.74 ± 0.50) ng / ml] and [(0.37 ± 0.03) ng / ml] and [(0.35 ± 0.02) <0.01. The level of sTNFR-p55 in ascites of hepatocellular carcinoma patients was also significantly higher than that in patients with cirrhosis [(1.11 ± 1.25) ng / ml] (P <0.01). Serum levels of sTNFR-p55 in patients with liver cancer and cirrhosis were significantly associated with ascites. Serum levels of sTNFR-p55 in HCC patients were positively correlated with TBil and AFP in peripheral blood (r = 0.524, P = 0.01 and r = 0.234, P = 0.03). Conclusion The detection of sTNFR-p55 has practical value in reflecting the abnormal immune status and tumor diagnosis of patients with liver cancer.