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目的:探讨颗粒酶B(granzyme B,GrB)在原发性肝细胞癌(HCC)、癌旁、肝硬化及正常肝组织中的表达,及GrB+淋巴细胞与HCC、肝硬化的关系。方法:HCC60例,单纯性肝硬化62例,正常肝组织23例,以免疫组化二步法进行GrB染色,对阳性细胞数进行定量分析。结果:①各组GrB+细胞平均数从高到低为:癌旁,HCC,正常肝,肝硬化组织;②HCC中 GrB+细胞与组织学分级无明显关系:(P>0.05);③HCC中15月内有转移组的GrB+细胞数明显少于无转移组:(P<0. 01);④HCC中GrB+细胞随着临床分期的发展有下降的趋势:(P<0.05);⑤以术前甲胎蛋白(AFP)阴、阳性分组(20μg/L 为标准),AFP阴性组和AFP阳性组两组数据无明显差异:(P>0.05);⑥肝硬化和癌旁组中乙型肝炎表面抗原(HBsAg) 阳性组GrB+细胞均多于阴性组:(P<0.05);HOC组GrB+细胞与HBsAg无密切相关:(P>0.05);⑦癌旁GrB+细胞与是否伴肝硬化无明显关系:(P>0.05)。结论:临床上,随着HCC患者的病情恶化,GrB+细胞逐渐减少。GrB+细胞数量与HBsAg密切相关,与组织学分级、AFP和是否伴有肝硬化无关。GrB+细胞也可成为反映机体抗肿瘤特异性细胞免疫状态及判断患者预后的重要指标之一。
OBJECTIVE: To investigate the expression of granzyme B (GrB) in primary hepatocellular carcinoma (HCC), paracancer, cirrhosis and normal liver tissues and the relationship between GrB + lymphocytes and HCC and liver cirrhosis. Methods: Sixty-six cases of HCC, 62 cases of simple cirrhosis and 23 cases of normal liver tissue were stained with GrB by immunohistochemical two-step method. The number of positive cells was quantitatively analyzed. Results: ① The average number of GrB + cells in each group was from high to low: paracancer, HCC, normal liver and cirrhosis tissues; ② There was no significant relationship between GrB + cells and histological grade in HCC (P> 0.05) The number of GrB + cells in the metastasis group was significantly less than that in the non-metastasis group in the month (P <0.01). (4) The GrB + cells in HCC had a tendency to decline with the development of clinical stage (P <0.05) There was no significant difference between AFP negative group and AFP positive group (P> 0.05); ⑥ There was no significant difference between AFP negative group and positive group (20μg / L) GrB + cells in HBsAg positive group were more than those in negative group (P <0.05); Grb + cells in HOC group were not closely related to HBsAg (P> 0.05); ⑦ GrB + With cirrhosis no significant relationship: (P> 0.05). Conclusion: Clinically, GrB + cells gradually decrease with the progression of HCC patients. The number of GrB + cells is closely related to HBsAg, but not with histological grade, AFP and cirrhosis. GrB + cells can also be one of the important indicators to reflect the anti-tumor-specific cellular immune status and prognosis of patients.