关键词: 肝癌, CD4⁺ T细胞, CD8⁺ T细胞, 肝功能

Abstract: Objective To investigate the correlations between subsets of peripheral lymphocytes and impaired liver function in liver cancer patients by assaying CD3⁺T cells, CD4⁺T cells, CD8⁺T cells and NK cells in vivo.Methods Fifty liver cancer patients in Shanghai Renji Hospital were enrolled in the retrospective analysis, containing 10 patients with primary liver cancer, 30 with secondary liver cancer and 10 with other liver diseases. CD3⁺T cells, CD4⁺T cells, CD8⁺T cells and NK cells in these patients were assayed using flow cytometry. Ten patients with other liver diseases were recruited as disease control group, and 40 healthy blood donors were recruited as normal control group. .Results Subsets of peripheral lymphocytes in primary liver cancer patients showed no differences with that in disease control group or normal control group. In secondary liver cancer patients, the proportion of CD4⁺T cells in peripheral blood was much lower than that in normal control group (29.18±2.11% vs 35.68±0.56%, P<0.05), while the proportion of NK cells was much higher (21.45±1.69% vs 15.78±0.72%, P<0.01). However, there was no difference in lymphocyte subsets between secondary liver cancer patients and disease control group. Proportion of CD4⁺T cells in primary liver cancer patients with hepatocellular injury was higher than that in patients without hepatocellular injury (45.90±5.96% vs 30.93±1.76%, P<0.05), which showed a positive correlation with alanine aminotransferase (ALT) (r=0.941, P<0.01) and aspartate aminotransferase (AST) (r=0.903, P<0.01). Proportion of CD8⁺T cells in primary liver cancer patients with damage of liver metabolic function was lower than that in patients with no damage (27.00±4.63% vs 34.01±7.98%, P<0.05), which had negative correlations with serum total bilirubin (STB) ( r=-0,596, P<0.05) and prothrombin time (PT) (r=-0.577, P<0.05). Secondary liver cancer patients with hepatocellular injury had a lower proportion of CD4⁺T cells (23.22±3.28% vs 33.24±2.29%, P<0.05), while a higher proportion of CD8⁺T cells (34.70±4.26% vs 25.84±1.99%, P<0.05) than those without hepatocellular injury. Ratio of CD4⁺/CD8⁺T cells had negative correlations with ALT (r=-0.470, P<0.05) and AST(r=-0.424, P<0.05). Secondary liver cancer patients with damage of liver metabolic function had a higher proportion of CD4⁺T cells than the patients with no damage group (35.64±2.84% vs 25.56±2.57%, P<0.05), and the ratio of CD4⁺/CD8⁺T cells was positively correlated with STB (r=0.400, P<0.05 ) and PT(r=0.481, P<0.05).Conclusion The subsets proportion of peripheral lymphocytes in liver cancer patients is closely related to the damage of liver function. The immune balance is of great importance to protect liver function for patients with liver cancer.

Key words: Liver cancer, CD4⁺ T cell, CD8⁺ T cell, Liver function