【作者】 任姗； 金怡； 何智敏； 刘亚莉； 何俊峰； 陈新月；

【Author】 ShanRen;Jin Yi;Zhimin He;Yali Liu;Junfeng Lu;Xinyue Chen;Beijing You,an Hospital,Capital Medical University;

【机构】 首都医科大学附属北京佑安医院肝病综合科；

【摘要】 目的分析抗程序性死亡配体-1(PD-L1)联合抗细胞毒T淋巴细胞相关抗原-4(CTLA-4)检测在原发性肝癌患者腹腔积液及外周血单个核细胞(PBMC)中的表达及其临床意义。方法选择2014年2月-2017年2月首都医科大学附属北京佑安医院肝病综合科诊治的腹腔积液患者189例作为研究对象,其中原发性肝癌恶性腹腔积液92例,肝硬化腹腔积液97例。采用酶联免疫吸附法(ELISA)、聚合酶链反应(PCR)检测患者腹腔积液、PBMC中PD-L1、CTLA-4的表达,并分析二者联合检测对原发性肝癌恶性腹腔积液的诊断价值。结果与肝硬化非恶性腹腔积液比较,原发性肝癌恶性腹腔积液患者PBMC中PD-L1、CTLA-4 mRNA,腹腔积液中PD-L1、CTLA-4表达含量显著增高(P<0.05);腹腔积液、PBMC中PD-L1与CTLA-4的表达均呈显著正相关(r=0.477,0.418,P<0.05);腹腔积液中PD-L1与CTLA-4联合检测敏感度、特异度分别为92.5%、94.7%,均高于腹腔积液脱落细胞及PD-L1与CTLA-4单独检测,亦高于PBMC的敏感度、特异度。结论原发性肝癌腹腔积液患者腹腔积液、PBMC中PD-L1与CTLA-4的表达与病因有关,可反映局部微环境下的免疫功能状态,联合检测有助于良恶性腹腔积液的鉴别诊断。更多还原

【Abstract】 Objective To investigate the expression and clinical significance of anti-programmed death ligand 1(PD-L1) combined with anti cytotoxic T lymphocyte associated antigen(CTLA-4) inascites and peripheral blood mononuclear cells(PBMC) in patients with HCC.Methods From Feb 2014 to Feb 2017 in Beijing You,an Hospital Affiliated Capital Medical University,189 patients who were diagnoses and treated of ascites were enrolled as the research object,including 92 cases of malignant ascites and 97 cases of liver cirrhosis asites.Enzyme linked immune sorbent assay(ELISA) and polymerase chain reaction(PCR) were used to detect the expression of PD-L1,CTLA-4 in PBMC of ascites and to analyze the diagnostic value of combined detection of two methods for malignant ascites.Results Compared with nonmalignant ascites in liver cirrhosis patients,PD-L1 and CTLA-4 mRNA in PBMC,and PD-L1 and CTLA-4 expression in ascites were significantly increased in HCC patients(P<0.05);There was the positive correlation between PD-L1 and CTLA-4 in PBMC and ascites(r=0.477,0.418,P<0.05).PD-L1 and CTLA-4 in ascites’ joint detection sensitivity and specificity were respectively 92.5% and 94.7%,which were higher than that of ascites exfoliated cells and PD-L1 or CTLA-4 expression in ascites separately,also its sensitively and specificity was higher than PBMC.Conclusion The expression of PD-L1,CTLA-4 in ascites,PMBC may be related to the etiology,which can reflect the immune function in the local microenvironment.更多还原