摘要
目的探讨原发性肝癌术后肝衰竭患者外周血单个核细胞（PBMCs）中CD163的阳性表达水平及其与患者预后的关系。方法选择2012年8月至2014年8月行肝切除术治疗的67例原发性肝癌患者作为研究对象,根据术后有无肝衰竭分为肝衰竭组（n=18）和无肝衰竭组（n=49）,随访6个月后根据发生肝衰竭患者的预后分为死亡组（n=4）和存活组（n=14）;并选择同期健康体检者80例作为对照组。采用流式细胞术对两组对象PBMCs中CD163的阳性表达水平进行测定和比较。结果肝衰竭组血小板计数、肝功能Child-pugh分级、术中出血量与无肝衰竭组比较差异有统计学意义（P〈0.01,P〈0.05）。PBMCs中CD163阳性表达水平,在肝衰竭组患者[（6.92±3.32）%]显著低于无肝衰竭组[（12.78±6.53）%,P〈0.01]和对照组[（21.74±9.96）%,P〈0.01];在肝衰竭晚期患者[（3.38±1.52）%]显著低于早期[（9.49±3.16）%,P〈0.01]和中期患者[（6.87±2.91）%,P〈0.05];在发生肝衰竭者中6个月后死亡组[（5.21±2.87）%]显著低于存活组[（9.16±2.39）%,P〈0.05]。CD163评估肝衰竭患者预后的ROC曲线下面积（AUC）为0.846（95%CI 0.747-0.945）。结论肝癌术后肝衰竭患者PBMCs中CD163阳性表达水平显著降低,且与患者的病情程度及预后密切相关。
Objective To investigate the positive expression level of CD163 in peripheral blood mononuclear cells（ PBMCs） and its relationship with prognosis in hepatocellular carcinoma patients with postoperative liver failure. Methods Sixty-seven patients with primary hepatic carcinoma treated by hepatectomy from August 2012 to August 2014 were selected as research objects. The patients were divided into liver failure group（ n = 18） and non liver failure group（ n = 49）according to with or without liver failure after operation. After a follow-up of six months,the liver failure patients were re-divided into death group（ n = 4） and survival group（ n = 14） according to the patients＇ prognosis. Eighty healthy subjects in the same period were selected as control group. Flow cytometry was used to detect and compare the CD163 positive expression level in PBMCs. Results There were significant differences in the platelet count,liver function Child-Pugh classification and intraoperative blood loss between liver failure group and non liver failure group（ P〈0. 01,P〈0. 05）. The CD163 positive expression level in PBMCs in liver failure group [（ 6. 92 ± 3. 32） %]was significantly lower than those in non liver failure group [（ 12. 78 ± 6. 53） %,P〈0. 01] and control group [（ 21. 74 ± 9. 96） %,P〈0. 01]. The CD163 positive expression level in PBMCs of patients with advanced stage liver failure [（ 3. 38 ± 1. 52） %]was significantly lower than those in patients with early-term liver failure [（ 9. 49 ± 3. 16） %,P〈0. 01] and mid-term [（ 6. 87 ± 2. 91） %,P〈0. 05]. After six months,the CD163 positive expression level in PBMCs in death group [（ 5. 21 ± 2. 87） %]was significantly lower than that in survival group [（ 9. 16 ± 2. 39） %,P〈0. 05]. The area under the ROC curve（ AUC） was 0. 846（ 95% CI： 0. 747-0. 945） for evaluating the prognosis of liver failure patients by CD163. Conclusion The positive expression level of CD163 in PBMCs in hepatocellular carcinoma patients with postoperative liver failure significantly decreases,and it is closely corre-lated with the degree of disease and prognosis.
出处
《中国临床研究》
CAS
2016年第8期1050-1053,共4页
Chinese Journal of Clinical Research
关键词
原发性肝癌
肝功能衰竭
CD163
单个核细胞
肝衰竭分期
预后
Primary hepatic carcinoma
Liver function failure
CD163
Mononuclear cells
Liver failure classification
Prognosis
