Relationship between peripheral blood lymphocyte subset and prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization

doi:10.3969/j.issn.1673-8640.2018.09.002

Abstract

Abstract:

Objective To investigate the relationship between peripheral blood lymphocyte subset and prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization （TACE）. Methods A total of 214 hepatocellular carcinoma patients undergoing TACE were enrolled. The preoperative ethylenediamine- tetraacetic acid whole blood samples were collected,and peripheral blood lymphocyte subset was determined by flow cytometry. The basic clinical data were collected. The data of magnetic resonance imaging （MRI） after TACE for 6 months and prognosis were evaluated. The patients were classified into 2 groups,including stable disease group （134 cases） and progressive disease group（80 cases）,according to MRI data. The difference of lymphocyte subset between the 2 groups and the independent risk factor of prognosis after TACE were analyzed. Results The cell percentages of CD4⁺ and CD4⁺CD8⁺ and the ratio of CD4⁺/CD8⁺ in stable disease group were lower than those in progressive disease group （P<0.05）. The cell percentages of CD19⁺,CD3⁺,CD8⁺ and CD56⁺ had no statistical significance （P>0.05）. Logistic regression analysis showed that the number of tumors,the cell percentage of CD4⁺and the cell percentage of CD4⁺CD8⁺ were independent risk factors for the prognosis of hepatocellular carcinoma after TACE [odds ratio （OR）=1.931,3.096 and 2.105,95% confidence interval （CI） 1.058-3.526,1.584-6.052 and 1.079-4.108]. Conclusions The increasing of preoperative CD4⁺ and CD4⁺CD8⁺ cell percentages may predict high possibility of poor prognosis in hepatocellular carcinoma patients after TACE.

Key words: Lymphocyte subset, Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Prognosis

CLC Number:

R446.1

MENG Zhimin, ZHU Jie, ZHANG Chunyan, GUO Wei, PAN Baishen, WANG Beili. Relationship between peripheral blood lymphocyte subset and prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization[J]. Laboratory Medicine, 2018, 33(9): 781-785.

Figures/Tables 5

References 14

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组别	例数	年龄				性别			AFP
组别	例数	<50岁		≥50岁		女		男	<400 ng/mL			≥400 ng/mL
疾病稳定组	134	29		105		14		120	77			57
疾病进展组	80	20		60		17		63	46			34
组别	ALT				HBsAg				肝硬化		肿瘤数量
组别	<75 U/L		≥75 U/L		阳性		阴性		是	否	单个		多个
疾病稳定组	105		29		101		33		114	20	89		45
疾病进展组	70		10		59		21		64	16	40		40
组别	肿瘤大小		血管侵袭		癌栓		肿瘤分期
组别	<5 cm	≥5 cm	存在	不存在	存在	不存在	BCLC 0~A	BCLC B~D
疾病稳定组	49	85	82	52	93	41	17	117
疾病进展组	34	46	43	37	32	48	9	81

组别	例数	年龄				性别			AFP
组别	例数	<50岁		≥50岁		女		男	<400 ng/mL			≥400 ng/mL
疾病稳定组	134	29		105		14		120	77			57
疾病进展组	80	20		60		17		63	46			34
组别	ALT				HBsAg				肝硬化		肿瘤数量
组别	<75 U/L		≥75 U/L		阳性		阴性		是	否	单个		多个
疾病稳定组	105		29		101		33		114	20	89		45
疾病进展组	70		10		59		21		64	16	40		40
组别	肿瘤大小		血管侵袭		癌栓		肿瘤分期
组别	<5 cm	≥5 cm	存在	不存在	存在	不存在	BCLC 0~A	BCLC B~D
疾病稳定组	49	85	82	52	93	41	17	117
疾病进展组	34	46	43	37	32	48	9	81

组别	例数	CD19⁺细胞（%）	CD3⁺细胞（%）	CD4⁺细胞（%）
疾病稳定组	134	15.52±7.80	65.24±10.87	39.69±7.01
疾病进展组	80	14.96±6.39	67.51±9.37	42.97±8.18
P值		0.569	0.122	0.002
组别	CD8⁺细胞（%）	CD56⁺细胞（%）	CD4⁺CD8⁺细胞（%）	CD4⁺/CD8⁺比值
疾病稳定组	22.79±7.67	16.55±7.81	2.31±1.45	1.99±0.96
疾病进展组	21.13±6.52	14.40±7.52	3.10±2.29	2.29±1.08
P值	0.109	0.051	0.003	0.031

组别	例数	CD19⁺细胞（%）	CD3⁺细胞（%）	CD4⁺细胞（%）
疾病稳定组	134	15.52±7.80	65.24±10.87	39.69±7.01
疾病进展组	80	14.96±6.39	67.51±9.37	42.97±8.18
P值		0.569	0.122	0.002
组别	CD8⁺细胞（%）	CD56⁺细胞（%）	CD4⁺CD8⁺细胞（%）	CD4⁺/CD8⁺比值
疾病稳定组	22.79±7.67	16.55±7.81	2.31±1.45	1.99±0.96
疾病进展组	21.13±6.52	14.40±7.52	3.10±2.29	2.29±1.08
P值	0.109	0.051	0.003	0.031

项目	单因素回归分析		多因素回归分析
项目	OR值（95%CI）	P值	OR值（95%CI）	P值
年龄（>50岁相对于≤50岁）	0.829（0.432~1.590）	0.572
性别（女性相对于男性）	0.432（0.200~0.934）	0.033	0.432（0.188~1.012）	0.058
AFP（>400 ng/mL相对于≤400 ng/mL）	0.998（0.570~1.748）	0.996
ALT（>75 U/L相对于≤75 U/L）	0.517（0.237~1.128）	0.098
HBsAg（阳性相对于阴性）	0.918（0.487~1.731）	0.791
肝硬化（存在相对于不存在）	0.829（0.408~1.683）	0.603
肿瘤数量（多个相对于单个）	1.978（1.123~3.484）	0.018	1.931（1.058~3.526）	0.032
肿瘤大小（>5 cm相对于≤5 cm）	0.780（0.443~1.373）	0.389
血管侵袭（存在相对于不存在）	1.357（0.775~2.376）	0.286
癌栓（存在相对于不存在）	1.512（0.848~2.698）	0.161
肿瘤分级（BCLC B~D相对于BCLC 0~A）	1.146（0.485~2.709）	0.756
CD4⁺细胞百分比（≥46%相对于<46%）	2.896（1.531~5.478）	0.001	3.096（1.584~6.052）	0.004
CD4⁺CD8⁺细胞百分比（≥3%相对于<3%）	1.293（1.080~1.593）	0.005	2.105（1.079~4.108）	0.029
CD4⁺/CD8⁺比值（≥2.5相对于<2.5）	1.698（0.897~3.214）	0.104