作者：曲玉虎 邱法波 刘国强
【摘要】 目的 研究重组人生长激素对原发性肝癌(PHC)手术切除后病人Th1/Th2漂移的影响。方法 以干扰素(IFN?γ)和白细胞介素2 (IL?2)代表Th1类细胞因子，白细胞介素4(IL?4)和白细胞介素10(IL?10)代表Th2类细胞因子，以逆转录聚合酶链反应(RT?PCR)检测16例原发性肝癌病人术前和术后10 d即应用重组人生长激素5 d后外周血单个核细胞(PBMC)Th1/Th2类细胞因子mRNA的表达，以20例原发性肝癌单纯手术切除病人作为对照组。结果 重组人生长激素组与单纯手术切除组比较，术前Th1类细胞因子表达无显著性差异(P>0.05);术后10 d重组人生长激素组Th1类细胞因子显著增高，与单纯手术切除组比较差异有显著性(Uc=2.58，P<0.01)。结论 短期应用重组人生长激素可促使PHC手术切除后病人免疫状态向Th1状态漂移。
【关键词】 肝肿瘤;人生长激素;Th1细胞;Th2细胞;细胞因子类;逆转录聚合酶链反应
[ABSTRACT] Objective To study the impact of recombinant human growth hormone (rhGH) on Th1/Th2 shift in patients with primary hepatic carcinoma (PHC) after surgical resection. Methods Using IFN?γ and IL?2 as Th1 cytokine genes, IL?4 and IL?10 as Th2 cytokine genes, the peripheral blood mononuclear cells (PBMC) of Th1/Th2?type cytokine mRNA expression in 16 PHC patients were detected by RT?PCR after using rhGH before and 10 days after surgery for five days, which was compared with 20 PHC patients treated with simple resection. Results Preoperatively, the expression of Th1?type cytokine between rhGH group and simple?surgery group was not significant (P>0.05); postoperatively, the expression of Th1 in rhGH group obviously increased at 10 days after surgery as compared with the control (Uc=2.58,P<0.01). Conclusion Short?term administration of rhGH may precipitate the patients’ immune drifting to Th1 state in patients undergoing surgery for PHC.
[KEY WORDS] Liver neoplasms; Human growth hormone; Th1 cells; Th2 cells; Cytokines; Reverse transcriptase polyme?rase chain reaction
研究显示，生长激素对人体免疫系统发育及调节具有重要作用,生长激素可增强机体的细胞免疫功能,促使NK细胞活性增强，使白细胞介素2(IL?2)和干扰素(IFN?γ)表达增强[1]。NK细胞是Th1类细胞，IL?2和IFN?γ是Th1类细胞因子，因此推测重组人生长激素可能促使机体免疫状态向Th1状态偏移。本研究以IL?2和IFN?γ代表Th1类细胞因子，白细胞介素4(IL?4)和白细胞介素10(IL?10)代表Th2类细胞因子，通过逆转录聚合酶链反应(RT?PCR)技术检测原发性肝癌术后短期应用重组人生长激素后外周血单个核细胞(PBMC)Th1/Th2细胞因子的表达，探讨短期应用重组人生长激素在肝癌切除后对机体Th1/Th2偏移的影响，现将结果报告如下。
1 资料和方法
1.1 一般资料
原发性肝癌病人36例，分为重组人生长激素组和单纯手术切除组。重组人生长激素组16例，男14例，女2例;年龄38～66岁，平均52.5岁;肝细胞性肝癌10例，胆管细胞性肝癌3例，混合细胞性肝癌3例;肿瘤直径4.4～8.2 cm; HBcAb(+)10例，HBsAg(+)10例，HBsAb(+)4例，HBeAg(+)1例，HBeAb(+)4例。单纯手术切除组20例，男16例，女4例;年龄39～61岁，平均49.8岁;肝细胞性肝癌18例，胆管细胞性肝癌2例;肿瘤直径3.3～10.3 cm;HBsAg(+)18例，HBsAb(+)2例，HBeAg(+)2例，HBeAb(+)10例，HBcAb(+)18例。