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慢性乙型肝炎患者外周血淋巴细胞比例低预示着肝细胞癌进展不良。

Low Frequency of Peripheral Lymphocyte in Chronic Hepatitis B Patients Predicts Poor Progression to Hepatocellular Carcinoma.

作者信息

Li Jian, Li Juan, Bao Yunwen, Pan Kunyi, Lin Xianghua, Liu Xiaoqiang, Wang Han, Xu Ying, Luo Xiaohong, Li Hongyu, Duan Chaohui

机构信息

Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.

Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

出版信息

J Clin Lab Anal. 2016 May;30(3):208-15. doi: 10.1002/jcla.21838. Epub 2015 Jan 19.

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is the fifth most prevalent cancer and the second leading cause of cancer-related deaths worldwide. The poor prognosis of HCC is mainly because of its discovery at advanced stages. Because chronic hepatitis B (CHB) accounts for 50-80% HCC occurrence worldwide, and immunity is regarded as an emerging hallmark of cancer, we investigated the predictive role of peripheral immune cells in HCC incidence in CHB patients.

METHODS

This investigation collected and analyzed data from 89 CHB patients, 94 primary HCC patients with hepatitis B virus (HBV), 81 primary HCC patients without HBV, 69 normal healthy patients, and 257 CHB patients with at least 3-year regular followup.

RESULTS

The results demonstrated that CHB and primary HCC patients had different concentrations of lymphocytes, neutrophils, and monocytes in their peripheral circulation. Further study showed that the peripheral lymphocyte concentration was an independent prognostic factor for HCC incidence in CHB patients during the 3 years of followup. Finally, a predictive HCC incidence model with an AUROC (area under the receiver operating characteristic) of 0.832 was constructed based on the peripheral lymphocyte concentration, serum alpha-fetoprotein (AFP) concentration, and cirrhosis status of CHB patients.

CONCLUSIONS

The peripheral lymphocyte concentration was an independent prognostic factor for HCC incidence in CHB patients, and a more accurate predictive model based on peripheral lymphocytes, serum AFP, and cirrhosis status was constructed.

摘要

背景

肝细胞癌(HCC)是全球第五大常见癌症,也是癌症相关死亡的第二大主要原因。HCC预后较差主要是因为其在晚期才被发现。由于慢性乙型肝炎(CHB)占全球HCC病例的50 - 80%,且免疫被视为癌症的一个新特征,我们研究了外周免疫细胞在CHB患者HCC发病中的预测作用。

方法

本研究收集并分析了89例CHB患者、94例乙型肝炎病毒(HBV)相关的原发性HCC患者、81例非HBV相关的原发性HCC患者、69例正常健康患者以及257例至少有3年定期随访的CHB患者的数据。

结果

结果表明,CHB患者和原发性HCC患者外周循环中的淋巴细胞、中性粒细胞和单核细胞浓度不同。进一步研究表明,外周淋巴细胞浓度是CHB患者随访3年期间HCC发病的独立预后因素。最后,基于CHB患者的外周淋巴细胞浓度、血清甲胎蛋白(AFP)浓度和肝硬化状态构建了一个曲线下面积(AUROC)为0.832的HCC发病预测模型。

结论

外周淋巴细胞浓度是CHB患者HCC发病的独立预后因素,并且构建了一个基于外周淋巴细胞、血清AFP和肝硬化状态的更准确的预测模型。

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