Preoperative immune factors in patients with primary hepatocellular carcinoma and their relationship with pathological characteristics

doi:10.11958/20251548

Abstract

Abstract:

Objective To analyze changes of preoperative T lymphocyte immunity and humoral immunity, and their relationship with pathological characteristics in patients with primary hepatocellular carcinoma (HCC). Methods A total of 150 patients with primary HCC underwent elective surgical treatment were enrolled as the HCC group, while 150 healthy controls during the same period were enrolled as the control group. Before surgery, the levels of peripheral blood CD3⁺, CD4⁺ and CD8⁺ were detected by flow cytometry, and CD4⁺/CD8⁺was calculated. The levels of IgA, IgG and IgM in peripheral blood were detected by immunoturbidimetry. The pathological characteristics of HCC patients were collected, and the differences of preoperative immune indexes in patients with different pathological characteristics were compared. The receiver operating curve (ROC) was used to evaluate the predictive value of immune indicators for pathological characteristics. Results The levels of CD3⁺, CD4⁺and CD4⁺/CD8⁺ were lower in the HCC group than those in the control group, while levels of CD8⁺, IgA, IgG and IgM were higher in the HCC group than those in the control group (P<0.05). The levels of CD3⁺, CD4⁺and CD4⁺/CD8⁺ were lower in patients with lymph node metastasis than those of patients with distant lymph non-metastasis (P<0.05). The levels of CD8⁺, IgA, IgG and IgM were higher in patients with lymph node metastasis than those of patients without metastasis (P<0.05). The results of receiver operating characteristic (ROC) curves showed that area under the curve (AUC) values of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺, IgA, IgG, and IgM for predicting lymph node metastasis in HCC patients were 0.810, 0.741, 0.770, 0.707, 0.756, 0.738 and 0.727. Conclusion There are abnormal changes of preoperative T lymphocyte immunity and humoral immunity in patients with primary HCC, which are closely related to lymph node metastasis.

Key words: carcinoma, hepatocellular, immunity, cellular, immunity, humoral, preoperative, pathological characteristic

CLC Number:

R735.7

Figures/Tables 5

References 22

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组别		n	CD3⁺/%	CD4⁺/%	CD8⁺/%
对照组		150	71.30±3.76	48.95±5.25	25.57±2.67
HCC组		150	56.89±5.03	32.35±4.66	37.22±4.05
t			28.077^＊＊	28.953^＊＊	29.407^＊＊
组别	CD4⁺/CD8⁺		IgA/（g/L）	IgG/（g/L）	IgM/（g/L）
对照组	1.90±0.50		3.15±0.58	11.28±2.49	2.24±0.66
HCC组	0.90±0.22		6.95±1.29	16.61±3.45	6.66±1.25
t	22.392^＊＊		32.992^＊＊	15.345^＊＊	38.272^＊＊

组别		n	CD3⁺/%	CD4⁺/%	CD8⁺/%
对照组		150	71.30±3.76	48.95±5.25	25.57±2.67
HCC组		150	56.89±5.03	32.35±4.66	37.22±4.05
t			28.077^＊＊	28.953^＊＊	29.407^＊＊
组别	CD4⁺/CD8⁺		IgA/（g/L）	IgG/（g/L）	IgM/（g/L）
对照组	1.90±0.50		3.15±0.58	11.28±2.49	2.24±0.66
HCC组	0.90±0.22		6.95±1.29	16.61±3.45	6.66±1.25
t	22.392^＊＊		32.992^＊＊	15.345^＊＊	38.272^＊＊

病理特征	n	CD3⁺/%	CD4⁺/%	CD8⁺/%	CD4⁺/CD8⁺
肿瘤直径
<5 cm	43	56.41±5.00	32.77±4.41	37.14±3.71	0.88±0.22
5~10 cm	71	57.31±5.52	32.78±4.40	36.93±4.41	0.91±0.21
>10 cm	36	56.65±4.03	31.00±5.28	37.88±3.71	0.91±0.22
F		0.475	2.023	0.672	0.238
肿瘤数量
1~2枚	67	56.79±4.24	31.71±4.38	37.12±4.03	0.89±0.23
≥3枚	83	56.98±5.62	32.86±4.84	37.30±4.09	0.91±0.20
t		0.226	1.507	0.263	0.536
门脉癌栓情况
有	64	57.53±5.21	32.29±4.61	37.20±4.38	0.88±0.21
无	86	56.42±4.88	32.39±4.73	37.23±3.81	0.92±0.21
t		1.344	0.123	0.044	1.128
肝外转移
有	70	56.84±4.85	32.65±4.44	36.83±4.07	0.90±0.21
无	80	56.86±5.24	32.06±4.86	37.57±4.02	0.90±0.22
t		0.021	0.776	1.121	0.003
微血管侵犯
M0	59	57.81±5.59	32.06±4.66	37.60±4.16	0.90±0.23
M1	43	56.07±4.52	32.48±4.58	37.69±4.03	0.92±0.18
M2	48	56.51±4.66	32.59±4.81	36.32±3.87	0.89±0.23
F		1.713	0.189	1.756	0.170
淋巴结转移
有	66	55.89±4.64	31.33±4.56	38.05±3.80	0.84±0.21
无	84	57.68±5.22	33.15±4.61	36.56±4.15	0.95±0.21
t		2.197^＊	2.402^＊	2.266^＊	3.040^＊
肿瘤分化程度
Ⅰ级	47	57.48±5.46	32.78±4.26	36.77±3.97	0.91±0.17
Ⅱ级	38	56.41±4.57	32.80±4.70	37.98±3.94	0.93±0.22
Ⅲ级	42	57.05±5.25	31.95±4.42	37.46±3.96	0.87±0.23
Ⅳ级	23	56.18±4.61	31.43±5.53	36.41±4.54	0.89±0.27
F		0.495	0.645	0.999	0.460
HCC分期
Ⅰ期	51	56.68±4.78	31.72±5.48	37.05±3.80	0.89±0.21
Ⅱ期	58	56.55±5.56	32.08±4.15	36.81±4.08	0.92±0.21
Ⅲa期	41	57.64±4.59	33.51±4.10	38.01±4.29	0.88±0.23
F		0.626	1.871	1.124	0.483

病理特征	n	CD3⁺/%	CD4⁺/%	CD8⁺/%	CD4⁺/CD8⁺
肿瘤直径
<5 cm	43	56.41±5.00	32.77±4.41	37.14±3.71	0.88±0.22
5~10 cm	71	57.31±5.52	32.78±4.40	36.93±4.41	0.91±0.21
>10 cm	36	56.65±4.03	31.00±5.28	37.88±3.71	0.91±0.22
F		0.475	2.023	0.672	0.238
肿瘤数量
1~2枚	67	56.79±4.24	31.71±4.38	37.12±4.03	0.89±0.23
≥3枚	83	56.98±5.62	32.86±4.84	37.30±4.09	0.91±0.20
t		0.226	1.507	0.263	0.536
门脉癌栓情况
有	64	57.53±5.21	32.29±4.61	37.20±4.38	0.88±0.21
无	86	56.42±4.88	32.39±4.73	37.23±3.81	0.92±0.21
t		1.344	0.123	0.044	1.128
肝外转移
有	70	56.84±4.85	32.65±4.44	36.83±4.07	0.90±0.21
无	80	56.86±5.24	32.06±4.86	37.57±4.02	0.90±0.22
t		0.021	0.776	1.121	0.003
微血管侵犯
M0	59	57.81±5.59	32.06±4.66	37.60±4.16	0.90±0.23
M1	43	56.07±4.52	32.48±4.58	37.69±4.03	0.92±0.18
M2	48	56.51±4.66	32.59±4.81	36.32±3.87	0.89±0.23
F		1.713	0.189	1.756	0.170
淋巴结转移
有	66	55.89±4.64	31.33±4.56	38.05±3.80	0.84±0.21
无	84	57.68±5.22	33.15±4.61	36.56±4.15	0.95±0.21
t		2.197^＊	2.402^＊	2.266^＊	3.040^＊
肿瘤分化程度
Ⅰ级	47	57.48±5.46	32.78±4.26	36.77±3.97	0.91±0.17
Ⅱ级	38	56.41±4.57	32.80±4.70	37.98±3.94	0.93±0.22
Ⅲ级	42	57.05±5.25	31.95±4.42	37.46±3.96	0.87±0.23
Ⅳ级	23	56.18±4.61	31.43±5.53	36.41±4.54	0.89±0.27
F		0.495	0.645	0.999	0.460
HCC分期
Ⅰ期	51	56.68±4.78	31.72±5.48	37.05±3.80	0.89±0.21
Ⅱ期	58	56.55±5.56	32.08±4.15	36.81±4.08	0.92±0.21
Ⅲa期	41	57.64±4.59	33.51±4.10	38.01±4.29	0.88±0.23
F		0.626	1.871	1.124	0.483

病理特征	n	IgA/（g/L）	IgG/（g/L）	IgM/（g/L）
肿瘤直径
<5 cm	43	7.11±1.08	16.55±2.84	6.36±1.36
5~10 cm	71	6.76±1.40	16.52±3.69	6.80±1.23
>10 cm	36	7.13±1.27	16.87±3.69	6.74±1.10
F		1.447	0.135	1.746
肿瘤数量
1~2枚	67	6.90±1.30	17.00±3.23	6.85±1.21
≥3枚	83	6.99±1.28	16.30±3.61	6.51±1.27
t		0.447	1.229	1.668
门脉癌栓情况
有	64	6.87±1.39	16.23±3.31	6.61±1.37
无	86	7.01±1.21	16.89±3.54	6.70±1.16
t		0.683	1.162	0.393
肝外转移
有	70	6.97±1.33	16.56±3.22	6.52±1.31
无	80	6.99±1.23	16.63±3.66	6.78±1.19
t		0.093	0.124	1.302
微血管侵犯
M0	59	6.89±1.39	16.76±3.15	6.55±1.20
M1	43	6.92±1.42	16.24±3.86	6.88±1.25
M2	48	7.06±1.03	16.77±3.46	6.60±1.31
F		0.170	0.243	0.348
淋巴结转移
有	66	7.28±1.21	17.40±3.53	6.91±1.30
无	84	6.70±1.30	15.99±3.27	6.46±1.18
t		2.806^＊＊	2.527^＊	2.237^＊
肿瘤分化程度
Ⅰ级	47	6.92±1.32	16.48±3.63	6.68±1.21
Ⅱ级	38	7.00±1.22	16.23±3.43	6.71±1.39
Ⅲ级	42	6.90±1.35	16.64±3.31	6.70±1.06
Ⅳ级	23	7.03±1.29	17.46±3.44	6.45±1.46
F		0.074	0.635	0.258
HCC分期
I期	51	7.09±1.24	16.66±3.1	6.62±1.14
Ⅱ期	58	6.84±.1.18	16.37±3.46	6.71±1.29
Ⅲa期	41	6.94±1.49	16.89±3.86	6.63±1.34
F		0.521	0.276	0.081