Abstract: Objective To investigate peripheral blood Th22 cells and plasma interleukin-22 （IL-22） level changes in patients with hepatocellular carcinoma（HCC） after hepatectomy and administration of ulinastatin. Methods A total of 88 patients with HCC were recruited in Department of General Surgery,Kunming General Hospital of PLA between July 2015 and April 2017,and all patients underwent hepatectomy. After the operation, 51 received routine supporting therapies and 37 received ulinastatin treatment for seven days. Thirty healthy individuals were also enrolled serving as normal controls （NC）. Peripheral blood mononuclear cells （PBMC） and plasma were isolated and percentage of CD3⁺CD4⁺IL-22⁺ Th22 cells were investigated by flow cytometry,and plasma IL-22 levels was measured by enzyme linked immunosorbent assay. The differences of Th22 percentages and IL-22 levels were compared between patients with HCC and NC. The independent samples t test was used for comparison of normally distributed continuous data, and Mann-Whitney test was used for comparison of continuous data with skewed distribution. Results Peripheral blood Th22 cell percentage in HCC patients was（1.4±0.3）%, significantly elevated than that in NC [（0.8±0.1）%,P<0.0001];plasma IL-22 level in HCC patients was （116.9±32.6） pg/ml,significantly higher than that in NC（42.1±18.2） pg/ml（P<0.01）;serum ALT level in ulinastatin-treated group and routine treatment group were [219.4（40.1,510.9） IU/L and 450.6 （56.1,820.7） IU/L,P<0.05] at the end of 3 days post-operation,and serum AST level in ulinastatin-treated group and routine treatment group were [108.8（82.5,439.1） IU/L and 257.3（115.3,7265） IU/L,P<0.01],respectively;serum ALT level in ulinastatin-treated group and routine treatment group were [72.4（25.6,471.5） IU/L and 115.4（35.7,625.2） IU/L,P<0.05] at the end of 7 days post-operation,and serum AST level in ulinastatin-treated group and routine treatment group were[61.4（29.4,351.4） IU/L and 90.5（45.5,293.8） IU/L,P<0.05],respectively;peripheral blood Th22 cell percentages were （1.2±0.4） % and （1.1±0.3） % at day 3 and at day 7 post-operation in ulinastatin- treated group,respectively,notably lower than those in routine treatment group [（1.3±0.3） %,P<0.05 and （1.3±0.2） %,P<0.05];plasma IL-22 levels were （98.1±20.1） pg/ml and（94.1±24.7） pg/ml in ulinastatin-treated group, respectively,significantly lower than those in routine treatment group[（109.7±29.8） pg/ml,P<0.05 and（110.7±37.1） %,P<0.05]. Conclusion Ulinastatin treatment might down-regulate peripheral blood Th22 cell counts and plasma IL-22 levels,showing liver function protection in patients with HCC after hepatectomy.

Key words: Hepatocellular carcinoma, Hepatectomy, Ulinastatin, Th22 cells, Interleukin-22