外周血细胞免疫与中晚期宫颈癌患者生存率相关性分析  

Correlation analysis between peripheral cellular immunity and survival rate in patients with advanced cervical cancer

作　　者：韩晓栋[1] 张继东[1] 杨迁妮[2] Han Xiaodong;Zhang Jidong;Yang Qianni(Second Department of Abdominal and Pelvic Radiotherapy,Shanxi Cancer Hospital,Taiyuan030013,China;不详)

机构地区：[1]山西省肿瘤医院放疗腹部盆腔二病区,太原030013 [2]山西省肿瘤医院放疗腹部消化三病区,太原030013

出　　处：《中国药物与临床》2020年第19期3180-3183,共4页Chinese Remedies & Clinics

摘　　要：目的宫颈癌患者放化疗前后外周血免疫功能指标进行监测,探索机体外周血免疫细胞绝对值与预后的关系。方法2014年6月至2016年8月在我院住院的195例宫颈癌患者进行同步放化疗,测量放化疗前后外周血免疫功能指标,统计并且观察细胞免疫与患者预后的关系。结果放化疗后,淋巴细胞总数及所有亚型均显著下降(P<0.05),Kaplan-Meier单因素生存分析:放疗前FIGO分期、淋巴结转移、外周血淋巴细胞总数、T细胞总数、细胞毒T细胞、辅助性T细胞、NK细胞、放化疗后淋巴细胞总数,辅助性T细胞与宫颈癌患者30个月总生存率相关,Log-Rank整体生存率比较差异有统计学意义(P<0.05)。通过多因素COX比例风险回归分析,分期与淋巴结是否转移为中晚期宫颈癌独立预后相关因素,分期:95%CI(0.149,0.988),P=0.047,HR=3.943。有无淋巴结转移:95%CI(0.231,0.946),P=0.034,HR=4.476。结论中晚期宫颈癌患者治疗前后外周血淋巴细胞绝对值与患者预后相关,可以考虑为患者预后的参考因素,分期与淋巴结转移是独立预后因素。Objective To track the peripheral immune function in patients with cervical cancer before and after chemoradiotherapy,and to investigate the relationship between the absolute value of peripheral immune cells and prognosis.Methods A total of 195 patients with cervical cancer treated in our hospital between June 2014 and August 2016 were enrolled and received concurrent chemoradiotherapy.The patients were measured for peripheral immune function before and after the chemoradiotherapy.The correlation between cellular immunity and patient prognosis was analyzed.Results After chemoradiotherapy,the patients experienced significant reductions in total counts and subsets of lymphocytes(P<0.05).Univariate Kaplan-Meier survival analysis showed that,the FIGO staging,lymph node metastasis,counts of total peripheral lymphocytes,total T cells,cytotoxic T cells,helper T cells,and NK cells prior to radiotherapy,counts of total lymphocytes and helper T cells after concurrent chemoradiotherapy,correlated with the 30-month overall survival rate in these cervical cancer patients.The differences in overall survival rate according to these factors were statistically significantly by Log-rank test(P<0.05).Multivariate COX proportional hazard regression showed that tumor staging(95%CI=0.149,0.988,P=0.047,HR=3.943)and lymph node metastasis(95%CI=0.231,0.946,P=0.034,HR=4.476)were independent prognostic factors for advanced cervical cancer.Conclusion The absolute value of peripheral lymphocytes before and after treatment is related to the prognosis of the patients with advanced cervical cancer,and therefore can be considered as a factor for the prognostication.Tumor staging and lymph node metastasis are independent prognostic factors of advanced cervical cancer.

关 键 词：宫颈肿瘤 免疫测定 细胞毒T细胞 

分 类 号：R737.33[医药卫生—肿瘤]