中晚期宫颈鳞癌患者治疗前外周血Treg计数分析  

Pre-treatment circulating regulatory T cell count analysis of advanced cervical squamous cell carcinoma patients

作　　者：郑雨薇[1] 黄啸[2] 郭林[3] 杨文韬[1] 吴佳文[1] 平波[1] 

机构地区：[1]复旦大学附属肿瘤医院病理科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院妇瘤科,复旦大学上海医学院肿瘤学系,上海200032 [3]复旦大学附属肿瘤医院检验科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2015年第4期241-246,共6页China Oncology

基　　金：国家自然科学基金青年科学基金资助项目(81101956/H1621)

摘　　要：背景与目的：中晚期宫颈鳞癌同期放化疗（concurrent chemoradiotherapy,CCRT）治疗前性价比高的疗效判断方法较有限,该研究拟通过检测治疗前外周血CD4＋CD25＋CD127Low/-调节性T细胞（regulatory T cells,Tregs）亚群计数及血清鳞癌抗原（squamous cell carcinoma antigen,SCC-Ag）水平,评价两者预测临床疗效的可行性。方法：采集44例ⅡB~ⅣA期宫颈鳞癌患者行CCRT治疗前的外周血标本,分别利用流式细胞免疫表型分析和酶联免疫法检测外周血CD4＋CD25＋CD127Low/-Treg计数及血清SCC-Ag水平。收集临床和病理资料,并统计检验2个指标对疗效的预测作用。结果：治疗前外周血CD4＋CD25＋CD127Low/-Treg计数在临床有效组低于无效组[（8.78±2.80）%vs（10.95±2.56）%,P〈0.05],血清SCC-Ag在不同临床疗效组间差异无统计学意义,且这2个指标之间未发现相关性（Spearman’rho=-0.093,P=0.540）。经受试者工作特征（receiver operating characteristic,ROC）曲线确定治疗前外周血CD4＋CD25＋CD127Low/-Treg及血清SCC-Ag最佳界值分别为9.76%与9.50 ng/m L。单因素分析显示,治疗前外周血CD4＋CD25＋CD127Low/-Treg计数（OR=1.901,95%CI：1.112~3.219,P=0.017）对CCRT疗效有预测作用,而血清SCC-Ag水平无预测作用（OR=0.998,95%CI：0.001~4.253,P=0.897）。多因素Logistic回归分析显示,治疗前外周血CD4＋CD25＋CD127Low/-Treg为独立的临床疗效预测因子（OR=3.115,95%CI：1.253~7.742,P=0.014）。结论：治疗前外周血CD4＋CD25＋CD127Low/-Treg计数用于中晚期宫颈鳞癌患者CCRT临床疗效预测具有可行性。Background and purpose： Due to the lack of cost-effective pre-treatment predictors for advanced cervical squamous cell carcinomas treated with concurrent chemoradiotherapy （CCRT）, both baseline circulating CD4＋CD25＋CD127Low/- regulatory T cell （Treg） count and serum squamous cell carcinoma antigen （SCC-Ag） level were measured for this feasibility study. Methods： Peripheral blood samples were collected from 44 patients with stage II B-IVA cervical squamous carcinomas before CCRT. Flow cytometry immunophenotyping and enzyme-linked immtmosorbent assay were used for circulating CD4＋CD25＋CD127Low/- Treg count and serum SCC-Ag level testing,respectively. Clinical and pathological characteristics were retrospectively reviewed to analyze the predictive value of the 2 indexes. Results： The baseline circulating CD4＋CD25＋CD127Low/- Treg count was lower in the patient group with positive treatment response than in the group with negative response [ （8.78±2.80）% vs （10.95±2.56）%, P〈0.05 ] , and the serum SCC-Ag level showed no significant difference between the 2 groups. No correlation was detected between these 2 markers （Spearman＇rho=-0.093, P=0.540）. Determined by plotting receiver operating characteristic curves, the best cut-off points were 9.76% for circulating CD4＋CD25＋CD127Low/- Treg count and 9.50 ng/mL for serum SCC- Ag level, respectively. Univariate analysis showed that pretherapeutic circulating CD4＋CD25＋CD127Low/- Treg count （OR=l.901, 95%CI： 1.112-3.219, P=-0.017）, but not serum SCC-Ag level （OR=0.998, 95%CI： 0.001-4.253, P=0.897）, was predictive of clinical response to CCRT. Multivariate Logistic regression analysis revealed that pre-treatment CD4＋CD25＋CD127Low/- Treg count was an independent predictor for clinical response to CCRT （OR=3.115, 95%CI： 1.253-7.742, P=-0.014）. Conclusion： Pretherapeutic circulating CD4＋CD25＋CD127Low/- Treg count is a feasible method to predict clinical response to CCRT in patients with advanced cer

关 键 词：中晚期宫颈鳞状细胞癌 同期放化疗 调节性T细胞 血清鳞状细胞癌抗原 

分 类 号：R737.33[医药卫生—肿瘤]