原发性肝癌和乙型肝炎肝硬化患者外周血淋巴细胞凋亡率、T细胞亚群和NK细胞的水平变化和临床意义

目的通过检测乙型肝炎肝硬化和合并乙型肝炎病毒感染的原发性肝细胞癌患者的外周血的粒细胞、单核细胞、NK细胞、T细胞及其亚群和淋巴细胞及其凋亡率,探讨两者在细胞免疫方面的差异.方法用Ficoll Hypaque离心法分离外周血单个核细胞(PBMNC),流式细胞仪检测外周血T细胞及其亚群、NK细胞和淋巴细胞、单核细胞和粒细胞,AnnexinV/FITCKit检测凋亡细胞.结果乙型肝炎肝硬化患者的外周血单核细胞、粒细胞、淋巴细胞、CD3-CD16 CD56 NK细胞、CD3 T细胞、CD3 CD4 T细胞、CD3 CD4 T细胞和CD4 CD8 T细胞比值,均与正常对照组无显著性差异(P＞0.05);但淋巴细胞凋亡率明显低于对照组(P＜0.01).原发性肝癌外周血CD3-CD16 CD56 NK细胞、单核细胞和CD4 /CD8 T细胞比值与肝硬化组和正常对照组比较,均无显著性差异(P＞0.05),而粒细胞明显升高(P＜0.05);CD3 T细胞、CD3 CD4 T细胞和CD3 CD8 T细胞均较另两组明显减少(P＜0.05),淋巴细胞及其凋亡率均明显低于另两组(P＜0.01).结论乙型肝炎肝硬化患者的外周血细胞免疫只发生不显著的变化,但淋巴细胞的凋亡率明显降低.原发性肝癌外周血的细胞免疫和淋巴细胞凋亡率均明显低下.

Changes and significance of levels of lymphocyte apoptosis, T cell subsets and NK cells in peripheral blood of patients with hepatitis B associated cirrhosis and primary hepatocellular carcinoma

Objective By detecting changes of granulocytes,lymphocyte,monocyte, natural killer(NK) cell,T cell subsets and lymphocyte apoptosis in peripheral blood of patients with hepatitis B associated cirrhosis and hepatitis B virus associated primary hepatocellular carcinoma,to investigate the differences of cell immune.Methods By using Ficoll Hypaque method to isolate the peripheral blood mono-nuclear cell(PBMNC) from blood specimens,we checked the levels of granuloandandcytes,lymphocytes,monocytes, NK cells,T cell subsets in peripheral blood by flow cytometry.Apoptosis cells were determined by Annexin V/FITC kit.Results There were not significant differences in levels of granulocytes,lymphocytes, CD3~-CD16~+CD56~+NK cells,CD3~+T cells,CD3~+CD4~+T cells,CD3~+CD8~+T cells,ratio of CD4~+/CD8~+T cells between ocirrhosis patients and control(p>(0.05)),but lymphocyte apoptosis rate was decreased markedly in cirrhosis(p<0.05).There were not marked differences in levels of CD3~-CD16~+CD56~+NK cells,monocytes,ratio of CD4~+T/ CD8~+T cells among primary hepatocellular carcinoma,cirrhosis and the control(p>0.05),but granulocytes were increasd significantly(p<0.05) and CD3~+T cells,CD3~+CD4~+T cells, CD3~+CD8~+T cells were decreased markedly in hepatocellular carcinoma(p<0.05).Lymphocytes and lymphocyte apoptosis in carcinoma were lowest of among three groups(p<0.001).Conclusion There were no significant changes of cell immune,but lymphocyte apoptosis was decreased markedly in peripheral blood of patients with hepatitis B associated hepatocirrhosis. Cell immune and lymphocyte apoptosis were decreased markedly in peripheral blood of patients with primary hepatocellular carcinoma.