Objective: To investigate the changes of immune function and its correlation with biliary tract infection before and after biliary stent in malignant obstructive jaundice.
Methods: A total of 148 patients from September 2014 to 2016 were collected in our hospital, the level of glycosylated haemoglobin, white blood cells, CD4+ T cell count, CD8+ T cell count and CD4+/CD8+ ratio, neutrophil count and percentage of neutrophil etc., total bilirubin, alanine aminotransferase, plasma hs-CRP, TNF-α, IL-1β, IL-6, IL-8 were recorded and compared before and after surgery.
Results: After a follow-up of 6 weeks, the CD4+ T lymphocytes count was significantly increased than that of before surgery (F=10.23, P=0.02). After follow-up of 6 weeks, the proportion of CD4+/CD8+ increased to 2.37 ± 1.09%, compared with that of before biliary stent implantation 0.71 ± 0.21%, the difference was statistically significant (F=21.74, P=0.02). 3 weeks after operation, hs-CRP, TNF-α, IL-1β, IL-6, IL-8, the levels of total bilirubin, alanine aminotransferase were significantly lower than that before operation (F=12.83, 18.45, 29.4, 12.8, 10.6, 9.29, 10.08; P=0.03, 0.01, 0.01, 0.02, 0.02, 0.00, 0.01, respectively). High risk factors for increasing CD4+/CD8+ ratio were investigated with patients of malignant obstructive jaundice, which includes blood glucose, glycosylated hemoglobin, ALT, AST, LDL-C, HDL-C and triglycerides, hs-CRP, neutrophil count, neutrophil percentage, T lymphocyte count, ratio of CD4+/CD8+ and biliary tumor size.
Conclusion: For patients with malignant obstructive jaundice, biliary stent could improve cholestasis by increasing the proportion of CD4+/CD8+ T lymphocytes, which can improve immune system, function for patients with malignant obstructive jaundice.Author(s): Chengli Liu, Cheng Wang, Hui Zhang, Xiaoxia Zang, Gang Zhao, Yalin Kong, Yingjie Wang, Hongqi Li