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Changes of immune function and its correlation with biliary tract infection before and after biliary stent in malignant obstructive jaundice

Chengli Liu, Cheng Wang, Hui Zhang, Xiaoxia Zang, Gang Zhao, Yalin Kong, Yingjie Wang, Hongqi Li

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.