目的：探讨肝癌患者外周血和癌组织中CD8+CD28-Foxp3+调节性T细胞（CD8+CD28-Foxp3+Tregs）的改变及意义。 方法：采用流式细胞仪检测72例肝癌患者和22例健康对照人群外周血CD8+CD28-Foxp3+T细与CD8+T细胞比值（CD8+CD28-Foxp3+Tregs/CD8+T），分析CD8+CD28-Foxp3+Tregs/CD8+T与肝癌患者临床病理因素的关系；分别用免疫组化和Western blot检测肝癌患者癌组织及癌旁组织中Foxp3阳性细胞与Foxp3蛋白表达水平。 结果：与健康对照人群比较，肝癌患者外周血CD8+CD28-Foxp3+Tregs/CD8+T明显升高（P<0.05）；外周血CD8+CD28-Foxp3+Tregs/CD8+T与患者TNM分期、淋巴结转移、分化程度有关（均P<0.05）；肝癌组织中平均Foxp3阳性细胞数与Foxp3蛋白表达量均明显高于癌旁组织（均P<0.05）；外周血CD8+CD28-Foxp3+Tregs/CD8+T，肝癌组织Foxp3阳性细胞数与Foxp3蛋白表达量在高、中、低分化的肝癌中均呈依次升高趋势，但差异均无统计学意义（均P>0.05）。 结论：CD8+CD28-Foxp3+Tregs在肝癌患者外周血及癌组织中增多，可能与肿瘤免疫抑制作用有关，其检测对肝癌患者病情有一定评估价值。
Changes in CD8+CD28–Foxp3+ regulatory T cells in patients with hepatocellular carcinoma
Objective: To investigate the changes in CD8+CD28–Foxp3+ regulatory T cells (CD8+CD28–Foxp3+Tregs) in peripheral blood and tumor tissue of patients with hepatocellular carcinoma (HCC) and the significance. Methods: The ratio of CD8+CD28–Foxp3+Tregs to CD8+T cells (CD8+CD28–Foxp3+Tregs/CD8+T) in peripheral blood in 72 HCC patients and 22 healthy controls was determined by flow cytometry, and the relations of CD8+CD28–Foxp3+Tregs/CD8+T with clinicopathologic factors of the HCC patients were analyzed. The Foxp3 positive cells and Foxp3 protein expression in tumor tissues and their adjacent tissues from HCC patients were determined by immunohistochemical staining and Western blot analysis, respectively. Results: The peripheral blood CD8+CD28–Fop3+Tregs/CD8+T was significantly increased in HCC patients compared with that in healthy controls (P<0.05), and the peripheral blood CD8+CD28–Fop3+Tregs/CD8+T was significantly associated with the TNM stage, lymph node metastasis and degree of tumor differentiation of the HCC patients (all P<0.05). The average number of Foxp3 positive cells and Foxp3 protein expression level were significantly higher in tumor tissue than those in adjacent tissue (both P<0.05). The peripheral blood CD8+CD28–Fop3+Tregs/CD8+T, and number of Foxp3 positive cells and Foxp3 protein expression level in tumor tissue all presented an increasing trend in the order of well, moderately and poorly differentiated HCC, but all differences did not reach a statistical significance (all P>0.05). Conclusion: CD8+CD28–Fop3+Tregs are increased in the peripheral blood and tumor tissue of HCC patients, which may probably be related to tumor immunosuppression, and their detection may have certain value in assessing the disease states of the HCC patients.