本文選題：肝腫瘤 + 肝炎病毒��； 參考：《臨床肝膽病雜志》2016年03期

【摘要】：目的探討陰虛型HBV相關原發(fā)性肝癌(PLC)患者的腫瘤特征及淋巴細胞計數與生化指標的相關性。方法收集2013年7月-2015年2月于首都醫(yī)科大學附屬北京地壇醫(yī)院治療的PLC患者148例,分為陰虛型PLC組(n=52)和非陰虛型PLC組(n=96)。收集患者的一般資料及實驗室指標,包括腫瘤學指標[甲胎蛋白(AFP)、癌胚抗原(CEA)、糖類抗原(CA)19-9],病毒學指標(HBs Ag),腫瘤大體分型(結節(jié)型、塊狀型、巨塊型、彌漫型),影像學特征(門靜脈主干內徑、門靜脈癌栓、肝外轉移),生化指標[終末期肝病模型(MELD)評分、白細胞(WBC)、紅細胞(RBC)、血小板(PLT)、ALT、AST、TBil、GGT、ALP、白蛋白(Alb)、膽堿酯酶(CHE)、凝血酶原時間(PT)、凝血酶原活動度(PTA)]和淋巴細胞計數。符合正態(tài)分布的計量資料組間比較采用t檢驗,相關性分析采用Pearson相關分析;不符合正態(tài)分布的計量資料組間比較采用Mann-Whitney U檢驗,相關性分析采用Spearman相關分析。計數資料組間比較采用χ2檢驗。結果 2組患者的HBs Ag比較差異有統(tǒng)計學意義(χ2=5.658,P=0.017)。與非陰虛型PLC組相比,陰虛型PLC患者的CEA和CA19-9水平升高,2組間比較差異有統(tǒng)計學意義(U值分別為-2.200、-2.194,P值均0.05),MELD評分、TBil、PT升高(t=2.2、U=-2.0、U=-2.0,P值均0.05),PLT和PTA降低(U=-3.1、t=-2.5,P值均0.05),淋巴細胞、T淋巴細胞、CD8+T淋巴細胞、CD4+T淋巴細胞計數均降低(t=-2.7、U=-2.6、t=-2.2、U=-2.9,P值均0.05)。陰虛型PLC患者的CD4+T淋巴細胞計數與PLT、PTA呈正相關(r值分別為0.360、0.295,P值均0.05);CD8+T淋巴細胞計數與PLT、PTA呈正相關(r值分別為0.352、0.464,P值均0.05),與MELD評分、TBil、PT呈負相關(r值分別為-0.358、-0.378、-0.520,P值均0.05)。結論陰虛型PLC患者較其他證型肝癌患者肝臟合成功能更差、膽汁淤積更明顯、免疫功能更為低下,且患者的CD4+T淋巴細胞計數越低,凝血功能越差;CD8+T淋巴細胞計數越低,凝血功能和肝臟儲備功能均差。
[Abstract]:Objective to investigate the relationship between tumor characteristics, lymphocyte count and biochemical indexes in patients with HBV associated primary hepatocellular carcinoma (PLC-) with yin deficiency. Methods from July 2013 to February 2015, 148 PLCpatients treated in Beijing The Temple of Earth Hospital affiliated to Capital Medical University were divided into two groups: Yin-deficiency The Temple of Earth group (n = 52) and non-yin deficiency The Temple of Earth group (n = 96). The general data and laboratory data of patients were collected, including oncology, carcinoembryonic antigen (CEA), carbohydrate antigen (CAG) 19-9, virological index (HBs), gross tumor classification (nodular type, massive type, giant type). Diffuse type, imaging features (portal vein trunk diameter, portal vein tumor thrombus, extrahepatic metastasis, biochemical index [end stage liver disease model / MELDs] score; WBC, RBC, ALT, ALB, AlbN, cholinesterase, PTT, prothrombin activity (PTAs) and lymphocyte count. T test, Pearson correlation analysis and Mann-Whitney U test and Spearman correlation analysis were used in the comparison of measurement data with normal distribution and Pearson correlation analysis and without normal distribution respectively and with Mann-Whitney U test and Spearman correlation analysis respectively. 蠂 2 test was used to compare the counting data between groups. Results there was a significant difference in HBs Ag between the two groups (蠂 2 = 5.658%, P < 0.017). Compared with non-yin deficiency type PLC group, There were significant differences in CEA and CA19-9 levels between the two groups in Yin-deficiency type PLC patients with elevated levels of CEA and CA19-9. There were significant differences between the two groups. The P values were -2.200 and 2.194, respectively. The scores of TBilPT were 0.05PLT and 0.05PLT in T lymphocytes and CD4 T T cells in CD8 T lymphocytes in patients with Yin-deficiency type PLC. Both were 0.05PLT values and 0.05PLT values were lower than those in patients with PTA-3.1T cells. The lymphocyte counts were all decreased, the values of U ~ (2. 2) ~ (2. 2) ~ (2. 2) U ~ (2. 9) U ~ (2. 9) P were 0. 05 ~ 0. 5%. There was a positive correlation between CD4 T lymphocyte count and PLT PTA in patients with Yin-deficiency type. The positive correlation between CD 4 T lymphocyte count and PLT T lymphocyte count in PLC patients with Yin-deficiency type was 0.360 0. 295 and 0. 05% respectively. The positive correlation between CD4 T lymphocyte count and PLTT PTA was 0. 05% and 0. 05% respectively. The negative correlation between CD 4 T lymphocyte count and meld score was-0. 358U-0. 378- 0. 520g P, and 0. 05% P, respectively. The positive correlation between CD 4 T lymphocyte count and PLT T cell count was 0. 05%, P = 0. 05%, P = 0. 05%, P = 0. 05%. Conclusion the liver synthesis function, cholestasis and immune function of PLC patients with Yin-deficiency type are worse than those with other types of liver cancer, and the lower the CD4 T lymphocyte count, the lower the coagulation function and CD8 T lymphocyte count. The mean of coagulation function and hepatic reserve function were different.
【作者單位】： 首都醫(yī)科大學附屬北京地壇醫(yī)院;首都醫(yī)科大學重大傳染病防治協(xié)同創(chuàng)新中心;
【基金】：北京市自然科學基金(7142081) 首都中醫(yī)藥研究專項課題(14ZY05) 北京衛(wèi)生系統(tǒng)高層次人才培養(yǎng)項目(2013-3-026)
【分類號】：R512.62;R735.7
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本文編號：2041144