| Objective:Programmed death-1 (PD-1) expression was investigated in CD4+ and CD8+ T cells from hepatitis B virus (HBV)-infected patients at the chronic hepatitis B (CHB) infection, liver cirrhosis (LC), and hepatocellular carcinoma (HCC) stages. Research the relationship between clinical indicators and PD-1.Methods:Collected patients from December 2013 to January 2015.31 cases of CHB were enrolled for the test group(26males,11 females).32 cases of LC were enrolled for the test group (21males,11females).32 cases of HCC were enrolled for the test group(26males,6females).16 cases of healthy were enrolled for the control group(3males,13females). CHB group according to the use of antivirals situation can be divided into using antiviral drug group (16 cases) and unused antiviral drug group (21 cases).LC group, according to Child-Pugh classification is divided into 15 cases of grade A, B grade 14 cases, C grade 3 cases. HCC group, according to the BCLC stages is divided into 13 cases of grade A, B grade 14 cases, C grade of 5 cases. PD-1 expression in circulating CD4+T cells and CD8+T cells was detected by flow cytometry, at the same time, using flow cytometry to detect granulocyte differentiation antigen 64 (CD64) on peripheral blood the patient’s white blood cells.Hepatitis B DNA detected in patients with viral load. Detecting the following clinically relevant indicators:HBV viral load, alanine aminotransferase,aspartate aminotransferase, total bilirubin, NEU%,LYM%, C-reactive protein. Record the patient’s age, sex, and other clinical departments of basic information.Results:1、PD-1 expression levels in each of experimental group was significantly higher in control group, and the difference was statistically significant(P<0.05).Among CHB group and LC group and HCC group, PD-1 expression in CD4+T cells, was not statistically significant(P>0.05). Among CHB group and LC group and HCC group,PD-1 expression in CD8+T cells, HCC group is greater than the LC group and CHB group, the difference was statistically significant(P<0.05).2、In the CHB group, Compare PD-1 expression levels in used antiviral drugs group and Unused antiviral drugs group, the difference was not statistically significant (P> 0.05).In the LC group, Compare PD-1 expression levels among A grade and B grade and C grade, the difference was not statistically significant (P>0.05).In the HCC group, Compare PD-1 expression levels among A stage and B stage and C stage, the difference was not statistically significant (P>0.05). Compare 13 cases of Occult chronic hepatitis b patients with healthy. It was found that PD-1 expression in CD4+ and CD8+T cells was significantly higher in the experimental groups than control group, and the difference was statistically significant(P<0.01).3、The spearman correlation analysis showed that PD-1 expression in CD8+T cells was negatively correlated with ALB levels(r=-0.241 P=0.009) and NEU percentage (r=-0.235 P=0.011).However, PD-1 expression in CD8+T cells was positively correlated with CD64 level (r=0.225 P=0.015). PD-1 expression in CD4+T cells had negative correlation with ALB (r=-0.453 P=0.000)4、The area under receiver operator characteristic curve (AUC) of CD8PD-1, CD4PD-1, CD64, ALT, AST, ALB, TB were 0.516,0.509,0.322,0.491,0.322, 0.634,0.470.It showed that CD4PD-1 and CD8PD-1 and ALB had certain diagnostic value at the diseases caused by HBV infection. But the diagnostic value is not high.5、CD64 expression level in each of experimental group was significantly higher than control group, and the difference was statistically significant(P<0.05).among experiment groups,there was no statistically significant difference(P>0.05).The spearman correlation analysis showed that CD64 expression level was positively correlated with CRP (r=-0.220 P=0.017),and was negatively correlated with LYM (r=-0.215P=0.020)Conclusion:1、PD-1 expression levels in each of experimental group was significantly higher in control group(P<0.05).It showed that there was certain clinical application value at the diseases caused by HBV infection, if PD-1 expression levels were increased.2、PD-1 expression in both CD4+T cells and CD8+T cells among CHB group and LC group and HCC group, only PD-1 expression in CD8+T cells was correlated with the degree of liver injury in chronic hepatitis b virus (HBV) infection patients. The deeper liver was injured,the higher CD8PD-1 expressed. With the development of the disease, PD-1 expression in CD8+T cells was negatively correlated with ALB levels. We can considered PD-1 expression level as a risk factor about liver injury.3、PD-1 expression in CD4+ and CD8+ T cells was no statistically significant difference among Child-Pugh grades and BCLC stages. So PD-1 expression levels can’t be a new standard apply to Child-Pugh grades and BCLC stages.4、The spearman correlation analysis showed that the PD-1 expression in both CD4+T cells and CD8+T cells was negatively correlated with HBV viral load. Compare 13 cases of Occult chronic hepatitis b patients with healthy. It was found that PD-1 expression in CD4+and CD8+T cells was significantly higher in the experimental groups than control group. So PD-1 can be a differential diagnosis to Occult chronic hepatitis b patients.5、It showed that PD-1 expression level had a certain clinical application value at the diseases caused by HBV infection. In addition, with the development of the disease, the diagnostic value will rise. However, according to the Receiver operating characteristic, it showed that the diagnostic value of PD-1 is not high. Combine CD64 and CRP and NEU and LYM,it will play a part in auxiliary diagnosing the diseases caused by HBV infection, and also will works in identifying and monitoring. |
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