CAJ | 학술논문

目的：探讨原发性肝癌（primary liver cancer，PLC，简称肝癌）患者术后细胞免疫功能动态变化与复发的相关性。方法对2001~2010年在我院行肝癌根治性切除术后1个月以上的42例患者进行动态随访、追踪观察。每隔2个月对患者进行T淋巴细胞亚群检测。其中16例出现复发，26例未复发。同期检测10例健康志愿者为健康对照组。结果复发组与未复发组PLC患者术后CD3+、CD4+、CD8+T淋巴细胞均明显低于健康对照组，差异比较有统计学意义（P<0.05），复发组患者T淋巴细胞较未复发组低，以复发时最为明显，与未复发组比较差异有统计学意义（P<0.05）。随着术后无瘤生存时间的延长，复发组的CD4+和CD4+/CD8+的比值逐渐升高，CD8+、CD3+T淋巴细胞逐渐下降，而未复发组的CD4+、CD3+T淋巴细胞则随着术后时间的延长逐渐升高。结论 PLC患者术后普遍且比较持续地存在细胞免疫功能低下，患者细胞免疫功能低下可能是影响肝癌术后复发的重要因素。动态监测PLC患者术后的细胞免疫功能，可作为评估肝癌根治术后预后和潜在复发风险评估的指标之一。
목적：탐토원발성간암（primary liver cancer，PLC，간칭간암）환자술후세포면역공능동태변화여복발적상관성。방법대2001~2010년재아원행간암근치성절제술후1개월이상적42례환자진행동태수방、추종관찰。매격2개월대환자진행T림파세포아군검측。기중16례출현복발，26례미복발。동기검측10례건강지원자위건강대조조。결과복발조여미복발조PLC환자술후CD3+、CD4+、CD8+T림파세포균명현저우건강대조조，차이비교유통계학의의（P<0.05），복발조환자T림파세포교미복발조저，이복발시최위명현，여미복발조비교차이유통계학의의（P<0.05）。수착술후무류생존시간적연장，복발조적CD4+화CD4+/CD8+적비치축점승고，CD8+、CD3+T림파세포축점하강，이미복발조적CD4+、CD3+T림파세포칙수착술후시간적연장축점승고。결론 PLC환자술후보편차비교지속지존재세포면역공능저하，환자세포면역공능저하가능시영향간암술후복발적중요인소。동태감측PLC환자술후적세포면역공능，가작위평고간암근치술후예후화잠재복발풍험평고적지표지일。
Objective To explore the possible correlation between dynamic changes in immune function and postsurgical recurrence in patients with primary liver cancer. Methods We followed up 42 patients with primary liver cancer who had surgery between 2001 to 2010,and we measured levels of T lymphocyte subpopulations every two months.The measurements were also performed in 10 healthy control individuals.Percentages of lymphocyte subpopulations were compared between the patients and healthy controls,as well as between the 16 patients with recurrence during follow-up and the 26 patients without recurrence. Results Percentages of CD3+, CD4+,and CD8+cell populations were significantly higher in patients than in healthy controls (P<0.05).Among patients,T lymphocyte counts were significantly lower in the recurrence group than in the non-recurrence group (P<0.05). In the recurrence group,the CD4+subpopulation and CD4+/CD8+ratio increased with longer tumor-free time after surgery,while the CD8+and CD3+subpopulations de-creased.In the non-recurrence group,CD4+and CD3+subpopulations increased with longer tumor-free time after surgery. Conclusions Recurrence of primary liver cancer after surgery was associated with lower cellular immune function.Dynamic monitoring of cellular immunity may be useful for assessing recurrence risk and prognosis in primary liver cancer patients after surgery.