自身免疫性肝炎患者外周血NKp46+ILC3细胞和Th17细胞变化及其临床意义探讨*

doi:10.3969/j.issn.1672-5069.2023.01.011

摘要/Abstract

摘要： 目的研究自身免疫性肝炎(AIH)患者外周血NKp46⁺ILC3细胞和Th17细胞百分比变化及其临床意义。方法 2016年2月～2020年2月我院收治的AIH患者43例,使用流式细胞仪检测外周血NKp46⁺3型天然淋巴样细胞(ILC3)和Th17细胞百分比,应用受试者工作特征曲线(ROC)下面积(AUC)分析应用NKp46⁺ILC3细胞和Th17细胞百分比判断AIH患者肝组织炎症活动分级的效能。结果 10例临床重度AIH患者NKp46⁺ILC3细胞和Th17细胞百分比分别为(0.2±0.2)%和(1.3±0.4)%,显著低于或高于33例轻中度AIH患者【分别为(0.5±0.2)%和(0.8±0.3)%,P<0.05】;12例肝组织G3～4级AIH患者 NKp46⁺ILC3细胞百分比和Th17细胞百分比分别为(0.3±0.2)%和(1.3±0.4)%,显著低于或高于31例G1～2级AIH患者【分别为(0.5±0.2)%和(0.8±0.3)%,P<0.05】;以外周血NKp46⁺ILC3细胞百分比≤0.3%为截断点,判断AIH患者肝组织炎症重度活动的AUC为0.774(95% CI:0.592～0.957),其敏感度为75.0%,特异度为87.1%;以外周血Th17细胞百分比＞1.1%为截断点,判断AIH患者肝组织炎症重度活动的AUC为0.853(95% CI:0.734～0.973),其敏感度为66.7%,特异度为90.3%。结论 AIH患者外周血NKp46⁺ILC3细胞水平降低,而Th17细胞水平升高。应用这种变化规律可能有助于判断AIH患者肝组织炎症活动分级,对评估AIH患者病情具有一定的临床意义。

关键词: 自身免疫性肝炎, NKp46⁺ILC3细胞, Th17细胞, 临床意义

Abstract: Objective The aim of this study was to explore the implications of peripheral blood NKp46⁺ILC3 cells and Th17 cells in patients with autoimmune hepatitis (AIH). Methods 43 patients with AIH were encountered in our hospital between February 2016 and February 2020. The percentages of peripheral blood NKp46⁺ILC3 and Th17 positive mononuclear cells were detected by flow cytometry, and the area under receiver operating characteristic (ROC) curve (AUC) was adopted to analyze the efficacy of NKp46⁺ILC3 cells and Th17 cells in judging the liver histological activity grading in patients with AIH. Results The percentages of NKp46⁺ILC3 cells and Th17 cells in 10 patients with severe AIH were(0.2±0.2)% and (1.3±0.4)%, significantly lower or higher than [(0.5±0.2)% and (0.8±0.3)%, respectively, P<0.05] in 33 patients with mild to moderate AIH; the percentages of NKp46⁺ILC3 cells and Th17 cells in 12 AIH patients with liver histological activity G3 to G 4 were(0.3±0.2)% and (1.3±0.4)%, significantly lower or higher than [(0.5±0.2)% and (0.8±0.3)%, respectively, P<0.05] in 31 AIH patients with G1 to G2; the AUC was 0.774(95% CI:0.592-0.957), with the sensitivity (Se) of 75.0% and specificity (Sp) of 87.1% when the peripheral blood NKp46⁺ILC3 cells ≤0.3% was set as the cut-off-value, and the AUC was 0.853(95% CI:0.734-0.973), with Se of 66.7% and Sp of 90.3% when the peripheral blood Th17 cells ＞1.1% was set as the cut-off-value in judging severe liver histological activity grading. Conclusion The peripheral blood NKp46⁺ILC3 cells decrease, and that of Th17 cells increase in patients with AIH, and application of them might help judge the liver histological activity changes.

Key words: Autoimmune hepatitis, NKp46⁺ILC3 cells, Th17 cells, Clinical implication

王浩宇, 周娟燕, 刘茹, 徐菁, 马少君. 自身免疫性肝炎患者外周血NKp46⁺ILC3细胞和Th17细胞变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(1): 39-42.

Wang Haoyu, Zhou Juanyan, Liu Ru, et al. Changes of peripheral blood NKp46⁺ILC3 cells and Th17 cells in patients with autoimmune hepatitis[J]. Journal of Practical Hepatology, 2023, 26(1): 39-42.

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