Correlation Analysis Between Lymphocytes Subsets And Therapeutical Efficiency Of TACE Treating HCC Patients

Objects:To observe the distribution of CD3+, CD4+, CD8+T cells, CD4+CD25+CD127-Regulatory T cell(CD4+CD25+Tregs)and NK cells in peripheral blood of pre-and post-Transarterial chemoembolization (TACE) treatment of hepatocellular carcinoma (HCC) patients and evaluate the changes of immune function. To analyze the correlation of lymphocyte subsets and overall suvival time (OS) and progression-free survival (PFS) of HCC patients, and in order to screen a potential immune index to predict the prognosis and therapeutical efficiency of TACE.Methods:Using FCM to detect the proportions and numbers of CD3+, CD4+, CD8+T cells, CD4+CD25+Tregs and NK cells of138HCC patients pre-and post-TACE treatment. The variations among groupswere analyzed with ANOVA. The correlation of lymphocyte subsets and OS, PFS was analyzed by Pearman’s correlation analysis. Receiver operating characteristic analysis (ROC) curve was performed to determine the optimal cut-off levels for CD3+T cells, CD4+CD25+Tregs and TACE numbers with respect to prognosis. Kaplan-Meier survival curves were plotted and compared by the log-rank test. Multivariate analysis of prognostic factors was carried out using Cox proportional hazard model.Results:The median OS of HCC patients was20months, median PFS was10months. Among the138patients,85(61.6%) patients progressed, the2-year PFS rate was17.3%.56(40.6%) patients died, the2-year OS rate was39.2%. Tumor size, lymph node metastasis, cirrhosis, Child-Pugh, TNM stages and TACE numbers also influenced the OS of HCC patients. Tumor size, lymph node metastasis, vascular permeation and TNM stages influenced PFS of patients. The percentage of NK cells in HCC patients with Child A classification was higher than that of patients with Child B classification. The percentage of CD4+T cells was lower in advanced-stage HCC patients, compared to early-stage patients. Whereas, CD4+CD25+Tregs and NK cells significant increased in advanced-stage patients (P<0.05). Among the various subsets of lymphocytes, CD3+T cells were positively related with OS and PFS (P=0.018, P=0.000). CD4+CD25+Tregs had negative correlation with OS and PFS of patents (P=0.000, P=0.038). In univariate analysis, CD4+CD25+Tregs was one of risk factors of the OS in HCC patients. Instead, The CD4+CD25+Tregs fraction and absolute number in HCC patients with cirrhosis were significantly higher than those in patients without cirrhosis (P=0.002and P=0.029, respectively), at the same time, the patients with higher ferritin level had less CD4+CD25+Tregs than that with normal ferritin (P=0.045, P=0.027). After four times TACE treatment, CD4+CD25+Tregs reduced significantly(P<0.05).Conclusion:Among the subsets of lymphocytes detected by FCM, CD4+CD25+Tregs was the independent risk factor which influenced OS of HCC patients, CD3+T cells was the independent risk factor which influenced PFS of HCC patients. CD4+CD25+Tregs reduced significantly after TACE treatment four times. So we suppose CD4+CD25+Tregs could be regard as immunue index to predict the prognosis and therapeutical efficiency of TACE.