Tumor features and correlation between lymphocyte count and biochemical parameters in patients with hepatitis B vi-rus- associated primary liver cancer with Yin deficiency

Objective To investigate the tumor features and the correlation between lymphocyte count and biochemical parameters in patients with hepatitis B virus- associated primary liver cancer( PLC) with yin deficiency. Methods A total of 148 PLC patients who were treated in Beijing Ditan Hospital,Capital Medical University,from July 2013 to February 2015 were enrolled and divided into yin- deficiency PLC group( 52 patients) and non- yin- deficiency PLC group( 96 patients). The patients' general information and laboratory markers were collected,including oncological parameters( alpha- fetoprotein,carcinoembryonic antigen( CEA),and carbohydrate antigen 199( CA19- 9)),virological parameter( HBs Ag),gross type( nodular type,massive type,bulky type,and diffuse type),radiological features( main portal vein diameter,portal vein tumor thrombus,and extrahepatic metastasis),biochemical parameters( Model for End- Stage Liver Disease( MELD) score,white blood cell,red blood cell,platelet( PLT),alanine aminotransferase,aspartate aminotransferase,total bilirubin( TBil),gamma- glutamyl transpeptidase,alkaline phosphatase,albumin,cholinesterase,prothrombin time( PT),and prothrombin time activity( PTA)),and lymphocyte count. The t- test was applied for comparison of normally distributed continuous data between groups,and the Pearson correlation analysis was applied for correlation analysis. The Mann- Whitney U test was applied for comparison of non- normally distributed continuous data between groups,and the Spearman correlation analysis was applied for correlation analysis. The chi- square test was applied for comparison of categorical data between groups. Results HBs Ag showed a significant difference between the two groups( χ2= 5. 658,P = 0. 017). Compared with the non- yin- deficiency PLC group,the yin- deficiency PLC group had significantly increased CEA and CA19- 9( U =- 2. 200 and- 2. 194,both P < 0. 05),significantly increased MELD score,TBil,and PT( t = 2. 2,U=- 2. 0,U =- 2. 0,all P < 0. 05),and significantly reduced PLT and PTA( U =- 3. 1,t =- 2. 5,both P < 0. 05),as well as significantly reduced lymphocyte,T lymphocyte,CD8+T lymphocyte,and CD4+T lymphocyte( t =- 2. 7,U =- 2. 6,t =- 2. 2,U =- 2. 9,all P < 0. 05). In the PLC patients with yin deficiency,CD4+T lymphocyte count was positively correlated with PLT and PTA( r = 0. 360 and 0. 295,both P < 0. 05); CD8+T lymphocyte count was positively correlated with PLT and PTA( r = 0. 352 and 0. 464,both P < 0. 05)and was negatively correlated with MELD score,TBil,and PT( r =- 0. 358,- 0. 378,and- 0. 520,all P < 0. 05). Conclusion Compared with the liver cancer patients with other syndrome types,PLC patients with yin deficiency have a worse liver synthetic function,more significant cholestatic symptoms,and a lower immune function,and coagulation function tends to become worse when CD4+T lymphocyte count decreases. With the decreasing CD8+T lymphocyte count,coagulation function and liver reserve function become worse.