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目的:研究CD4(Th1)和CD8(Tc1)T细胞对肝癌患者的AFP的应答反应及其与临床特征的相关性,为其早期诊断与预防提供新策略。方法:研究对象为62例HCC患者,30例肝硬化患者及30例健康志愿者;重点分析CD4 T细胞和CD8 T细胞对HCC患者的AFP-衍生肽的反应;用胞内细胞因子检测法对IFN-γ进行检测。结果:抗AFP的Tc1反应检测阳性结果在对照组为28.5%,在OkudaⅠ期的肝癌患者中为25.0%,在Ⅱ或Ⅲ期的HCC患者中为31.6%。抗AFP Th1阳性反应仅在HCC患者中检测到。抗AFP Th1阳性反应在44.4%的Child-Pugh A级的HCC患者中检测到,但是在Child-Pugh B或C级中仅15.4%。Tc1型反应在Child-Pugh A级肝功的患者中为16.7%,在Child-Pugh B或C级患者中为46.2%。结论:抗AFP Th1应答更多出现在早期肝硬化的HCC的患者中,而抗AFP Tc1应答更可能出现在晚期肝硬化患者中,这些结论为抗肝癌疫苗药物设计提供了理论基础。
Objective: To investigate the response of CD4 (Th1) and CD8 (Tc1) T cells to AFP in patients with hepatocellular carcinoma and its correlation with clinical features, and to provide a new strategy for its early diagnosis and prevention. METHODS: Sixty-two patients with HCC, 30 patients with cirrhosis and 30 healthy volunteers were enrolled in this study. The responses of CD4 T cells and CD8 T cells to AFP-derived peptides in HCC patients were analyzed. Intracellular cytokine assays IFN-γ were detected. RESULTS: The positive Tc1 response to AFP was 28.5% in the control group, 25.0% in Okuda stage I HCC patients and 31.6% in stage II or III HCC patients. Anti-AFP Th1-positive responses were only detected in HCC patients. Anti-AFP Th1-positive responses were detected in 44.4% of Child-Pugh class A HCC patients, but only 15.4% in Child-Pugh class B or C. The Tc1-type response was 16.7% in patients with Child-Pugh class A liver function and 46.2% in Child-Pugh class B or C patients. CONCLUSIONS: The anti-AFP Th1 response appears more often in patients with early-stage cirrhosis of the liver and the anti-AFP Tc1 response is more likely to be present in patients with advanced cirrhosis. These conclusions provide the rationale for designing anti-hepatocellular vaccine drugs.