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肝细胞性肝癌患者外周血CD4⁺CD25⁺CD127^low T淋巴细胞异常表达危险因素分析

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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:: 38
期数:: 2021年9

页码:: 834-838

栏目:: 临床研究

出版日期:: 2021-09-05

文章信息/Info

Title:: Risk factors of abnormal expression of CD4⁺CD25⁺CD127^low T lymphocytes in peripheral blood of patients with hepatocellular liver cancer

作者:: 陈忠彪; 周大臣; 侯　辉; 张　彬; （安徽医科大学第二附属医院胆外胰外科一病区，安徽　合肥　230601）

Author(s):: CHEN Zhongbiao; ZHOU Dachen; HOU Hui; ZHANG Bin; (Department of Hepatobiliary Surgery,the Second Hospital of Anhui Medical University,Hefei 230601,Anhui Province,China)

关键词:: 肝细胞性肝癌; 调节性T细胞; CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞

Keywords:: hepatocellular liver cancerregulatory T cellCD4⁺CD25⁺CD127^low T lymphocytes/CD4⁺ T lymphocytes

分类号:: R735.7

DOI:: 10.7683/xxyxyxb.2021.09.007

文献标志码:: A

摘要:: 目的　探讨肝细胞性肝癌（HCC）患者外周血中CD4⁺CD25⁺CD127^lowT淋巴细胞占CD4⁺T淋巴细胞百分比(CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞)异常的危险因素。方法　选择2018年8月至2020年5月安徽医科大学第二附属医院收治103例HCC患者为研究对象，应用流式细胞仪检测患者外周血淋巴细胞，参照本院检验科室正常人群外周血CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞范围4.29%～6.17%，采用单因素分析探讨外周血CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞增高与HCC患者临床特征的相关性，多因素 logistic 回归分析HCC患者外周血CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞增高的危险因素，应用R3.6.1软件建立其临床预测Nomgram模型图。结果　HCC患者外周血CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞<6.17%者82例（79.6%），外周血CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞≥6.17%的HCC患者21例（20.4%）。单因素分析显示，HCC患者外周血CD4⁺CD25⁺CD127^low细胞/CD4⁺T增高与甲胎蛋白（AFP）有关(P<0.05)，与乙型肝炎病毒表面抗原、乙型肝炎病毒(HBV)-DNA、肿瘤数目、肿瘤直径、肝硬化、门脉癌栓等因素无关(P>0.05)；多因素logistic 回归分析结果显示,HCC患者外周血CD4⁺CD25⁺CD127^low细胞/CD4⁺T增高与AFP阴性、肝硬化，多发肿瘤有关(P<0.05)。Nomgram预测模型结果显示，肿瘤直径≥5 cm、肿瘤多发、合并肝硬化、伴有HBV-DNA<1 000 IU·mL^-1、抗病毒治疗干预HCC患者外周血CD4⁺CD25⁺CD127^low T淋巴细胞/CD4⁺T淋巴细胞增高的概率显著增大；HCC患者AFP阳性，其CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞增高的概率小。结论　AFP阴性、肿瘤单发、肝硬化是HCC患者外周血CD4⁺CD25⁺CD127^lowT淋巴细胞/CD4⁺T淋巴细胞异常增高的危险因素。

Abstract:: Objective　To investigate the risk factors of abnormal ratio of CD4⁺CD25⁺CD127^low T lymphocytes to CD4⁺ T lymphocytes (CD4⁺CD25⁺CD127^low T lymphocytes/CD4⁺ T lymphocytes) in peripheral blood of patients with hepatocellular carcinoma (HCC).Methods　One hundred and three patients with HCC treated in the Second Affiliated Hospital of Anhui Medical University from August 2018 to May 2020 were selected as the research objects.The peripheral blood lymphocytes of the patients were detected by flow cytometry.Referring to the range of 4.29%-6.17% of CD4⁺CD25⁺CD127^low T lymphocytes/CD4⁺ T lymphocytes in the normal population in our laboratory, univariate analysis was used to analyze the correlation between the increase of CD4⁺CD25⁺CD127^low T lymphocytes/CD4⁺ T lymphocytes value in peripheral blood and the clinical characteristics of HCC patients,multivariate logistic analysis was used to analyze the risk factors of the increase of CD4⁺CD25⁺CD127^low T lymphocytes/CD4⁺ T lymphocytes value in peripheral blood of HCC patients,and R3.6.1 software was used to establish its clinical prediction Nomgram model.Results　There was 82 (79.6%) cases of HCC patients with CD4⁺ CD25⁺ CD127^low T lymphocytes/CD4 ⁺ T lymphocytes< 6.17% and 21 (20.4%) cases of HCC patients with CD4 ⁺ CD25 ⁺ CD127^low T lymphocytes/CD4⁺ T lymphocytes≥ 6.17% .Univariate analysis showed that the increase of CD4⁺ CD25⁺ CD127^low T lymphocytes/CD4 ⁺ T lymphocytes in peripheral blood was associated with alpha fetoprotein(AFP) in HCC patients (P<0.05),there was no association between the increase of CD4⁺CD25⁺CD 127^low T lymphocytes/CD4⁺T lymphocytes and hepatitis B virus surface antigen (HBsAg),hepatitis B virus(HBV)-DNA,tumor number,tumor diameter,liver cirrhosis and portal vein tumor thrombus of HCC patients (P>0.05)multivariate logistic regression analysis showed that the increase of CD4⁺ CD25⁺ CD127^low T lymphocytes/CD4 ⁺ T lymphocytes in peripheral blood was correlated with AFP negative,liver cirrhosis and multiple tumors of HCC patients(P<0.05).The Nomgram prediction model showed that the probability of CD4⁺ CD25⁺ C127^low T lymphocytes/CD4 ⁺ T lymphocytes increased significantly in the HCC patients who had tumor diameter ≥5 cm,multiple tumors,liver cirrhosis,HBV-DNA<1 000 IU·mL^-1 and antiviral treatment interventionthe HCC patients with positively AFP had the lower probability of CD4 ⁺ CD25 ⁺ CD 127^low T lymphocytes/CD4 ⁺ T lymphocytes increase.Conclusion　AFP-negative,tumor single-shot,cirrhosis are the risk factor for abnormal increase of CD4 ⁺ CD25 ⁺ CD 127^low T lymphocytes/CD4 ⁺ T lymphocytes in peripheral blood of HCC patients.

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更新日期/Last Update: 2021-09-05