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目的探讨乙型肝炎相关性肝细胞癌(HCC)患者外周血调节性T细胞(Treg)频率与疾病病程的关系;观察氩氦冷冻消融治疗对HCC患者外周血Treg频率的影响,分析Treg频率与患者预后的相关性。方法采用流式细胞仪检测101例HCC患者外周血Treg频率,分析Treg频率与HCC进展的关系。对其中34例患者进行氩氦冷冻消融治疗,检测治疗前和治疗后患者外周血Treg频率和甲胎蛋白(AFP)水平,分析二者的变化规律及与肿瘤进展的相关性。结果HCC巴塞罗那分期(BCLC分期)早期患者的Treg频率为6.89%±1.27%,中期患者为9.13%±1.36%,进展期患者为10.12%±2.04%,终末期患者为13.4%±2.81%。氩氦刀冷冻消融治疗后,17例肿瘤缓解患者的Treg频率较术前降低,其中7例术前AFP阳性(AFP>20ng/ml)的患者术后Treg频率和AFP水平均降低;14例肿瘤进展患者的Treg频率较术前明显升高,其中9例术前AFP阳性患者术后Treg频率和AFP水平随肿瘤进展而升高。结论HCC患者Treg频率随肿瘤进展而逐渐升高。氩氦刀冷冻消融治疗可降低HCC患者的Treg频率;对于氩氦刀冷冻消融治疗前AFP阴性的HCC患者,AFP不能发挥良好的指示作用,但Treg频率升高可以作为肿瘤进展的标志。
Objective To investigate the relationship between the frequency of Tregs and the course of disease in patients with Hepatitis B-associated hepatocellular carcinoma (HCC). To observe the effect of argon-helium cryoablation on Tregs in peripheral blood of patients with HCC, Correlation of patient prognosis. Methods Tregs were detected by flow cytometry in 101 patients with HCC. The relationship between the Treg frequency and the progression of HCC was analyzed. Thirty-four of them were treated by argon-helium cryoablation, and the levels of Treg and AFP in peripheral blood were measured before and after treatment. The changes of the two were analyzed, and their correlations with tumor progression were analyzed. Results The Treg frequency was 6.89% ± 1.27% in the early stage of HCC Barcelona stage (BCLC stage), 9.13% ± 1.36% in the intermediate stage, 10.12% ± 2.04% in the advanced stage and 13.4% ± 2.81% in the terminal stage. After cryosurgery, the Treg frequency in 17 patients with remission was lower than that before operation, and 7 patients with preoperative AFP positive (AFP> 20ng / ml) had lower Treg frequency and AFP level after operation. In 14 patients with tumor The frequency of Treg in patients with advanced disease was significantly higher than that before the operation. Treg frequency and AFP level in 9 preoperative AFP positive patients increased with tumor progression. Conclusion The frequency of Treg in HCC patients gradually increases with tumor progression. Cryoablation with argon-helium cryoablation can reduce the Treg frequency in patients with HCC. AFP can not play a good role in the indication of AFP-negative HCC before cryoablation. However, the increase of Treg can be used as a marker of tumor progression.