口腔鳞癌患者外周血CD57^(+)细胞表达水平变化和预后的相关性  

Expression Patterns and Clinical Significance of Peripheral Blood CD57-Positive Cells in Patients with Oral Squamous Cell Carcinoma

作　　者：刘骁蕾 侯栋梁 冯芝恩[2] 赵磊 李博 葛永青 杨慧 孙保锦 LIU Xiaolei;HOU Dongliang;FENG Zhien;ZHAO Lei;LI Bo;GE Yongqing;YANG Hui;SUN Baojin(Radiation Oncology Department,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Oral and Maxillofacial-Head and Neck Oncology,Beijing Stomatological Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]北京首都医科大学附属北京世纪坛医院放疗科,北京100038 [2]北京首都医科大学附属北京口腔医院口腔颌面头颈部肿瘤科,北京100050

出　　处：《标记免疫分析与临床》2022年第5期795-800,828,共7页Labeled Immunoassays and Clinical Medicine

基　　金：首都卫生发展科研专项项目(编号:2018-4-2082)。

摘　　要：目的探讨口腔鳞癌患者外周血CD57^(+)细胞亚群变化及临床意义。方法入组2018年11月至2019年12月就诊的可手术的口腔鳞癌患者,根据临床分期分为早期组和局部中晚期组。采用流式细胞仪检测外周血CD3^(+)淋巴细胞、CD57^(+)细胞、CD57^(+)CD8^(+)T细胞、CD57^(+)CD4^(+)T细胞、CD57^(+)CD56^(+)CD16^(+)和CD57^(+)CD56^(-)CD16^(+)NK细胞计数;以CD57^(+)CD8^(+)T细胞比例水平中位数为界值,绘制Kaplan-Meier生存曲线,分析CD57^(+)CD8^(+)T细胞低水平组和高水平组生存风险。结果与早期患者相比,局部进展期的口腔鳞癌患者CD57^(+)淋巴细胞(P=0.001)和CD57^(+)CD8^(+)T淋巴细胞比例(P<0.001)均明显升高。局部中晚期患者CD3^(+)细胞比例与早期患者比较差异无统计学意义(P=0.759)。局部中晚期患者CD57^(+)CD56^(+)CD16^(+)细胞比例较早期患者变化不大(P>0.05),但局部中晚期患者CD57^(+)CD56^(-)CD16^(+)细胞较早期患者明显减少(P=0.015)。随访至少2年,无失访,最终共有17例患者死亡。Kaplan-Meier生存曲线显示,CD57^(+)CD8^(+)T细胞比例高水平组无疾病进展率较低水平组明显降低(Log-rankχ^(2)=5.4,P=0.02);总生存率较低水平组也明显降低(Log-rankχ^(2)=20.1,P<0.001)。COX多因素回归分析显示CD57^(+)CD8^(+)细胞水平可能是影响口腔鳞癌的独立因素。结论本研究发现口腔鳞癌外周血CD57^(+)细胞和CD57^(+)CD8^(+)T细胞表达水平与口腔鳞癌患者预后密切相关,对口腔鳞癌预后评估具有重要价值。Objective To determine the expression pattern and clinical significance of peripheral blood CD57-positive cells in patients with oral squamous cell carcinoma(OSCC).Methods Patients with operable OSCC were recruited from November,2018 to December,2019 and divided into the early stage and local-aggressive stage groups.Flow cytometry was utilized to test the distribution of peripheral blood CD3^(+)cells,CD57^(+)cells,CD57^(+)CD8^(+)T cells,CD57^(+)CD4^(+)T cells,CD57^(+)CD56^(+)CD16^(+)NK cells and CD57^(+)CD56^(-)CD16^(+)NK cells.Taking the median value of peripheral blood CD57^(+)CD8^(+)T cells levels of the OSCC group as the boundary value,Kaplan-Meier survival curve demonstrated the survival risk of the OSCC group with low and high levels of CD57^(+)CD8^(+)T cells.Results The levels of CD57^(+)cells(P=0.001)and CD57^(+)CD8^(+)T cells(P<0.001)in clinical local-aggressive stage groups increased more significantly than in clinical early stage.Similar level of CD3^(+)cells was shown in both local-aggressive stage group and early-stage group(P=0.759),and CD57^(+)CD56^(+)CD16^(+)NK cells had no difference between these two groups(P>0.05),while CD57^(+)CD56^(-)CD16^(+)NK cells of the early-stage group had a higher value than the local-aggressive stage group(P=0.015).All subjects were followed up for at least 2 years.No cases were dropped off and 17 deaths occurred among 91 patients during the follow-up.Kaplan-Meier curve indicated that patients with the high level CD57^(+)CD8^(+)T cell had significantly decreased progression-free survival(Log-rankχ^(2)=20.1,P<0.001)and overall survival(Log-rankχ^(2)=20.1,P<0.001)than patients with low level CD57^(+)CD8^(+)T cell.Multivariate analysis showed that levels of CD57^(+)CD8^(+)T cell was a significant factor for OS.Conclusion Expression level of CD57^(+)CD8^(+)T cells and CD57^(+)cells are closely related to prognosis of with OSCC patients,which has an important value in evaluating prognosis of OSCC patients.

关 键 词：口腔鳞癌 预后 T淋巴细胞 NK细胞 CD57 

分 类 号：R739.85[医药卫生—肿瘤]