摘要目的 探讨肝细胞癌(HCC)患者外周血单个核细胞表面Toll样受体(TLR)2和TLR4的表达情况及与小肠细菌过度生长(SIBO)的关系.方法 采用流式细胞术检测HCC患者(78例)、肝硬化患者(56例)和健康对照者(33例)外周血单个核细胞表面TLR2、TLR4的表达情况,并行乳果糖氢呼气试验检测小肠细菌过度生长情况.样本率的比较用x2检验,独立样本组间均数比较用t检验.结果 78例HCC患者中SIBO阳性56例(71.8%),56例肝硬化患者中SIBO阳性23例(41.1%),33例健康对照组中HBO阳性1例(3.0%),HCC患者SIBO发生率高于肝硬化组(x2=12.72,P<0.05)和健康对照组(x2=41.18,P<0.05);HCC患者TLR2、TLR4表达水平(100.55±24.22、42.76±15.96)均显著高于肝硬化组(67.42±18.36、24.38±8.68)和健康对照组(33.06±11.72、12.52±4.46)(P值均<0.05);且HCC患者中SIBO阳性者TLR2、TLR表达水平(108.75±20.40、48.31±14.98)高于SIBO阴性者(79.67±20.60、28.62±7.36)(P值均<0.05).结论 HCC患者TLR2和TLR4的表达及SIBO发生率明显高于肝硬化组和健康对照组,且SIBO阳性HCC患者TLR2、TLR4的高表达,SIBO可能通过TLR2、TLR4的表达促进HCC的进展.

abstractsObjective To investigate TLR2 and TLR4 expressional situation on the surface of peripheral blood mononuclear cells(PBMC)in patients with hepatocellular carcinoma(HCC)and their relationship with small intestinal bacterial overgrowth(SIBO).Methods Flow cytometry was used to detect TLR2 and TLR4 expressional situation on the surface of PBMC in 78 cases with HCC,56 cases with cirrhosis and 33 healthy controls.Furthermore,lactose hydrogen breath test(LHBT)was used to detect small intestinal bacterial overgrowth.Results Of the 78 cases with HCC,56 cases(71.8%)were SIBO-positive,23 cases(41.1%)were SIBO-positive in 56 cases with cirrhosis,and 1(3.0%)was SIBO-positive in 33 healthy controls.The incidence of SIBO in HCC patients was higher than cirrhosis patients(x2=12.72,P<0.05)and healthy controls x2=41.18,P<0.05).The expression levels of TLR2 and TLR4 in HCC patients(100.55±24.22,42.76±15.96)were significantly higher than cirrhosis(67.42±18.36,24.38±8.68)and healthy control group(33.06±11.72,12.52±4.46)(P< 0.05).Furthermore,the expression levels of TLR2 and TLR4 in SIBO-positive patients(108.75±20.40,48.1±14.98)were higher than SIBO-negative patients(79.67±20.60,28.62±7.36)(P<0.05).Conclusion The expression of TLR2 and TLR4 and the incidence of SIBO in HCC patients are significantly higher than cirrhosis and healthy control group.Moreover,the high expressions of TLR2 and TLR4 in SIBO-positive HCC patients may promote the development of HCC.