Studies On Systemic Cell-mediated Immunity In Patients With Hepatocellular Carcinoma And The Immunological Influence Of Liver Cancer Resection.

Objectives:The present study aims to evaluate the systemic cell-mediated immunity and its clinical significance in patients with hepatocellular carcinoma.The influence of liver cancer resection on cell-mediated immunity was also analyzed.Methods:By flow cytometric ananlysis the presence of peripheral blood T lymphocyte subsets in HCC patients and healthy donors were evaluated. The dynamic presence of peripheral T lymphocyte subsets before and after liver cancer resection was also studied.With enzyme-linked immunosorbent assay,the serum cytokines expression of HCC patients and healthy donors were measured.The relationship between the presence of T lymphocyte subsets,cytokine expression and HCC biologic characteristics and TNM stages were analyzed.Results:Compared with the healthy donors,there is significantly abnormal presence of peripheral T lymphocyte subsets,which is related with the HCC biology and TNM stages.CD4+/CD8+ ratio was negatively correlated with the frequency of CD4+CD25+ regulatory T lymphocyte and CD3+T lymphocyte.There was a significant positive correlation between the frequency of CD4+CD25+ regulatory T lymphocyte and CD3+CD45RO+T lymphocyte.Foxp3 positive T lymphocyte may downregulate the expression of CD8+GranzymeB+T cells.It is more specific and reasonable to denote regulatory T cells by CD4+CD25+Foxp3+ T lymphocytes than CD4+CD25+T lymphocytes.There is also a Th1/Th2 serum cytokine imbalance profile in HCC patients and the imbalance is related with HCC biology.There was a significant positive correlation between the expression of peripheral interleukin-10 and interferon-gamma which may imply that interleukin -10 can function as a immunostimulative factor in some conditions and there may be a synergy between the biologic function of peripheral interleukin-10 and interferon-gamma.Our results suggest that liver cancer resection may lead to a temporal enhancement of immunosuppression.However liver cancer resection may reduce the tumour-related regulatory T cells by abating the tumour load.There is a tendency to improve in cell-mediated immunity about one month after sugery.Conclusions:The cell-mediated immunity in HCC patients is in a immunosuppressive condition.The expression of peripheral T lymphocyte subpopulations could be served as the index to evaluate cellular immunity in hepatocellular carcinoma.The abnormal increase of transcription factor Foxp3 expression in peripheral lymphocyte may play an important role in regulate the immunosuppression in hepatocellular carcinoma.The immunosuppressive condition is related with the invasion and progression of HCC.Aberrantly increased peripheral regulatory T lymphocytes may play an important role in the early stage of hepatocellular carcinoma progression.Liver cancer resection may be helpful for the recovery of anti-tumour immunity.The perioperative period of HCC patients may be a beneficial window-phase for immune intervention and regulatory T cells may be served as a target cell.