摘要
目的探究Th17及其相关因子与乙型肝炎病毒相关性肝细胞癌(HBV-HCC)患者预后的关系。方法以2017年1月-2020年4月开封市传染病医院63例HBV-HCC患者为研究对象,采用流式细胞仪检测患者外周血Th17频率,并采用ELISA法检测患者血清Th17相关因子水平[白介素-17(IL-17)、IL-23、γ干扰素(IFN-γ)]。比较不同巴塞罗那临床肝癌(BCLC)分期患者Th17及相关因子水平,分析其与BCLC分期的相关性;分析Th17及相关因子与HBV DNA载量的相关性。所有患者均随访1年,根据生存情况分为死亡组及生存组,比较两组Th17频率及其相关因子水平,分析其与不良预后发生的关系及对预后的预测价值。结果终末期患者Th17细胞频率及IL-17、IL-23水平高于晚期、中期、早期患者,晚期患者Th17细胞频率及IL-17、IL-23水平高于中期、早期患者,中期患者Th17细胞频率及IL-17、IL-23水平高于早期患者,差异均有统计学意义(P均<0.05)。Th17细胞频率及IL-17、IL-23水平与BCLC分期成正相关(r=0.415、0.450、0.608,P均<0.01),IFN-γ水平与BCLC分期无相关性(r=-0.034,P>0.05)。IL-23和IL-17水平与HBV DNA载量成正相关(P均<0.05),IFN-γ水平和Th17细胞频率与HBV DNA载量无相关性(P均>0.05)。死亡组Th17细胞频率及IL-17、IL-23、IFN-γ水平高于生存组,差异均有统计学意义(P均<0.05)。Th17≥0.27%、IL-17≥18.02 pg/mL是影响不良预后发生的危险因素(P<0.05),Th17、IL-17预测预后的曲线下面积大于0.7。结论IL-23及IL-17水平与HBV HCC患者HBV DNA载量相关,Th17频率及IL-17水平升高是影响患者预后的危险因素,对预后具有预测价值。
Objective To explore the relationship between Th17,its related factors and prognosis of patients with hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC).Methods A total of 63 patients with HBV-HCC were enrolled as the research objects between January 2017 and June 2020.The frequency of peripheral blood Th17 was detected by flow cytometry.The levels of serum Th17-related factors[interleukin-17(IL-17),IL-23,interferonγ(IFN-γ)]were detected by ELISA.The levels of Th17 and its related factors in patients with different grading of clinic liver cancer were compared.And their correlation with BCLC grading was analyzed.The correlation between Th17,its related factors and HBV DNA load was analyzed.All patients were followed up for 1 year and divided into death group and survival group according to survival status.Th17 frequency and levels of related factors were compared between the two groups.Their relationship with poor prognosis and predictive value for prognosis were analyzed.Results Th17 frequency and levels of IL-17 and IL-23 were the highest in patients at terminal stage,followed by late state,middle stage and early late(P<0.05).Th17 frequency and levels of IL-17 and IL-23 were positively correlated with BCLC grading(r=0.415,0.450,0.608;all P<0.01),while IFN-γlevel was not correlated with BCLC grading(r=-0.034,P>0.05).IL-23 and IL-17 level were positively correlated with HBV DNA load(all P<0.05),while Th17 cell frequency and IFN-γlevels were not correlated with HBV DNA load(all P>0.05).Th17 cell frequency and levels of IL-17,IL-23 and IFN-γin death group were higher than those in survival group(all P<0.05).Th17 not lower than 0.27%and IL-17 not lower than 18.02 pg/mL were risk factors of poor prognosis(P<0.05).Area under the curve of Th17 and IL-17 for predicting prognosis were greater than 0.7.Conclusions Levels of IL-23 and IL-17 were correlated with HBV-DNA load in HBV-HCC patients.Increased Th17 frequency and IL-17 levels were risk factors of prognosis,which had predictive value for prognosis.
作者
雷鹏
李宝法
段军民
LEI Peng;LI Baofa;DUAN Junmin(Department of Gastroenterology,Infectious Disease Hospital of Kaifeng,Kaifeng,Henan 475000,China)
出处
《热带医学杂志》
CAS
2024年第1期107-111,共5页
Journal of Tropical Medicine
基金
河南省科技厅科技攻关项目(142102310009)
作者简介
雷鹏(1981-),男,副主任医师,本科,研究方向:临床感染科、肝病、肿瘤,E-mail:leipeng198110@163.com
