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目的探讨外周血内皮祖细胞(EPC)水平与原发性肝癌肝动-门静脉瘘(HA-PVS)形成的相关性。方法用流式细胞术测定20例健康对照组,22例慢性乙型肝炎组,30例无HA-PVS的肝癌组,28例有HA-PVS的肝癌组患者外周血EPC的水平。结果有瘘肝癌组患者外周血EPC占淋巴细胞的比例为(21.09±2.79)‰,无瘘肝癌组(12.72±3.05)‰,慢性乙型肝炎组(3.53±2.11)‰,健康对照组(2.98±2.64)‰。与健康对照组和慢乙肝组比较,两肝癌组EPC水平均升高,差异均有统计学意义(P<0.01)。有瘘肝癌组中,EPC升高更明显(P<0.01),块状型肝癌、自发性细菌性腹膜炎和门脉栓塞的发生率高,均与无瘘肝癌组存在统计学意义(P=0.031,P=0.036,P=0.044)。结论外周血EPC水平与原发性肝癌HA-PVS的形成有关,并能反映肝癌的类型、转移和预后。
Objective To investigate the correlation between the level of endothelial progenitor cells (EPC) in peripheral blood and the formation of hepatic artery-portal vein fistula (HA-PVS) in primary hepatocellular carcinoma. Methods Flow cytometry was used to detect the levels of EPCs in 20 healthy controls, 22 chronic hepatitis B patients, 30 HA patients without HA-PVS and 28 HA patients with HA-PVS. Results The percentage of peripheral blood EPCs to lymphocytes in patients with fistula and hepatocellular carcinoma was (21.09 ± 2.79) ‰, fistula-free hepatocellular carcinoma (12.72 ± 3.05) ‰, chronic hepatitis B (3.53 ± 2.11) ‰ and healthy controls ± 2.64) ‰. Compared with the healthy control group and the chronic hepatitis B group, the EPC levels in both hepatocellular carcinoma groups were increased, the differences were statistically significant (P <0.01). In fistula hepatocellular carcinoma group, the increase of EPC was more obvious (P <0.01), and the incidence of massive hepatocellular carcinoma, spontaneous bacterial peritonitis and portal vein embolism was higher than that of non-fistula hepatocarcinoma group (P = 0.031 , P = 0.036, P = 0.044). Conclusion The level of EPC in peripheral blood is related to the formation of HA-PVS in primary hepatocellular carcinoma and can reflect the type, metastasis and prognosis of hepatocellular carcinoma.