Abstract: Background　Liver cancer is one of the most common malignant tumors in clinic. The prognosis of liver cancer patients with diabetes mellitus is poor. Diabetes mellitus is associated with primary liver cancer （PLC），but whether diabetes mellitus increases the risk of PLC and becomes an independent risk factor for PLC is still unclear. Objective　To investigate the immune functions in patients with PLC complicated with diabetes. Methods　From 2016 to 2017，40 PLC inpatients （PLC group） from Department of General Surgery and Department of GI，Baotou Cancer Hospital were enrolled in this study. They were matched with a diabetes group，and a PLC with diabetes group at a ratio of 1︰1. All of them measured CD3＋，CD4＋，and CD8＋ cell counts，carbohydrate antigen 199 （CA199），carcinoembryonic antigen （CEA），a-feto-protein （AFP） and α-L-fucosidase （AFU） on admission or during receiving outpatient treatment，and CD4＋/CD8＋ ratio was calculated. Results　Three groups had significantly different prevalence rates of positive CD3＋ and CD8＋ cells，and abnormal CD4＋/CD8＋ ratio （P<0.05） . Pairwise comparisons showed that，compared with PLC with diabetes group，the prevalence rates of positive CD3＋ and CD8＋ cells were lower in diabetes group and PLC group （P<0.05），and abnormal CD4＋/CD8＋ ratio was lower in diabetes group（P<0.05）. The prevalence rate of positive CD8＋ cells differed significantly in PLC with diabetes patients by PLC stage （P<0.05）. In particular，it was lower in those with advanced-stage PLC than in those with early-stage or intermediate-stage of PLC （P<0.05）. Three groups showed obviously different mean levels of CA199，CEA and AFU （P<0.05）. Diabetes group demonstrated lower mean levels of CA199，CEA and AFU compared with other two groups （P<0.05）. The mean levels of CA199，CEA，AFP and AFU in both PLC group and PLC with diabetes group did not differ obviously by PLC stage （P>0.05）. Conclusion　PLC with diabetes patients showed decreased positive CD3＋ and CD8＋ cells，increased CD4＋/CD8＋，CA199，CEA and AFU，indicating that they had declined immune functions.

Key words: Liver neoplasms；Diabetes mellitus；T-lymphocyte subsets；Tumor markers, biological

摘要： 背景　肝癌是临床上最常见的恶性肿瘤之一，肝癌合并糖尿病的患者预后较差。糖尿病与原发性肝癌发病相关，但糖尿病是否增加原发性肝癌发病风险，是否成为原发性肝癌发病的独立风险因素仍不明确。目的　探讨原发性肝癌合并糖尿病患者机体免疫功能的临床价值。方法　选取2016—2017年包头市肿瘤医院普外科及消化内科确诊的原发性肝癌患者40例，每例原发性肝癌患者匹配糖尿病患者及原发性肝癌合并糖尿病患者各1例，分别纳入原发性肝癌组、糖尿病组、原发性肝癌合并糖尿病组。入院或门诊时检测患者CD3＋、CD4＋、CD8＋细胞阳性率，并计算CD4＋/CD8＋，检测糖类抗原199（CA199）、癌胚抗原（CEA）、甲胎蛋白（AFP）、α-L-岩藻糖苷酶（AFU）水平。结果　3组患者CD3＋、CD8＋细胞阳性率、CD4＋/CD8＋比较，差异均有统计学意义（P<0.05）。其中，原发性肝癌合并糖尿病组的CD3＋、CD8＋细胞阳性率低于原发性肝癌组、糖尿病组，CD4＋/CD8＋高于糖尿病组（P<0.05）。3组患者CA199、CEA、AFU比较，差异均有统计学意义（P<0.05）。其中，原发性肝癌合并糖尿病组、原发性肝癌组的CA199、CEA、AFU均高于糖尿病组（P<0.05）。不同分期的原发性肝癌合并糖尿病组患者的CD8＋细胞阳性率比较，差异有统计学意义（P<0.05）。其中，进展期患者的CD8＋细胞阳性率均低于早期、中期（P<0.05）。不同分期的原发性肝癌组、原发性肝癌合并糖尿病组患者CA199、CEA、AFP、AFU比较，差异均无统计学意义（P>0.05）。结论　原发性肝癌合并糖尿病患者的CD3＋、CD8＋细胞阳性率降低，CD4＋/CD8＋、CA199、CEA、AFU升高，机体免疫功能降低。

关键词: 肝肿瘤；糖尿病；T淋巴细胞亚群；肿瘤标记, 生物学