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目的 探讨原发性肝癌 (PLC)患者血中Th1、Th2细胞因子变化规律及患者机体细胞免疫功能低下的原因。方法 应用酶联免疫吸附试验 (ELISA)检测PLC患者、良性肝胆疾病及肝硬化患者外周静脉 (PV)及脾静脉 (SV)血中肿瘤坏死因子 α(TNF α)、粒细胞 巨噬细胞集落刺激因子 (GM CSF)及白细胞介素 4(IL 4)的含量。结果 PLC患者PV及SV血中TNF α、GM CSF含量 [(12 4.90± 48.81)ng/L ,(10 1.88± 47.2 4)ng/L ,(2 4.91± 12 .69)ng/L ,(2 2 .0 4± 12 .5 7)ng/L]低于良性病组 ,而IL 4含量 [(0 .92± 0 .3 6)ng/L ,(1.11± 0 .45 )ng/L]高于良性病组。Ⅱ、Ⅲ期PLC患者PV及SV血中TNF α、GM CSF含量低于Ⅰ期 ;IL 4含量高于Ⅰ期 ;Ⅱ、Ⅲ期PLC患者SV血中TNF α、GM CSF含量均低于PV血中含量 ,而SV血中IL 4含量则高于PV血中含量。结论 PLC患者机体存在着Th1、Th2细胞因子失衡 ;中、晚期PLC患者血中Th1细胞因子含量下降、Th2细胞因子含量升高 ;这可能是导致PLC患者细胞免疫功能下降的原因之一 ;中、晚期PLC患者的脾脏可能存在某些免疫抑制因素 ,并可能参与了抑制机体细胞免疫功能的形成过程。
Objective To investigate the changes of Th1 and Th2 cytokines and the cellular immune dysfunction in patients with primary liver cancer (PLC). Methods Serum levels of tumor necrosis factor α (TNF α) and granulocyte-macrophage colony stimulating factor (PMN) were measured in patients with PLC, benign hepatobiliary diseases and cirrhosis by using enzyme-linked immunosorbent assay (ELISA) (GM CSF) and interleukin 4 (IL 4) content. Results The levels of TNFα and GM-CSF in PV and SV blood in PLC patients were significantly lower than those in PLC patients [(12 4.90 ± 48.81) ng / L, (10 1.88 ± 47.2 4) ng / L, (2.49.1 ± 12.69) ng / 2 .0 4 ± 12. 5 7) ng / L] was lower than that of benign disease group, while IL 4 content [(0.92 ± 0.36) ng / L, (1.11 ± 0.45) ng / L] Higher than benign disease group. The levels of TNFα and GM-CSF in PV and SV blood of patients with stage Ⅱ and Ⅲ PLC were lower than those of stage Ⅰ, the levels of IL 4 were higher than those of stage Ⅰ. The levels of TNFα and GM-CSF in patients with stage Ⅱ and Ⅲ PLC were lower than that of patients with PV While the content of IL 4 in SV blood was higher than that in PV blood. Conclusion There is an imbalance of Th1 and Th2 cytokines in PLC patients. The level of Th1 cytokines and Th2 cytokines in blood of patients with PLC are lower than those of PLC patients. This may be one of the reasons leading to the decrease of cellular immune function in PLC patients. There may be some immunosuppressive factors in the spleens of patients with advanced PLC and may be involved in the inhibition of the formation of cellular immune function.