肿瘤浸润淋巴细胞数量、微卫星不稳定性与大肠癌分期的相关性及对预后的评估价值分析  

Analysis of the correlation of the number of tumor infiltrating lymphocytes,microsatellite instability with staging of colorectal cancer and its prognostic value

作　　者：张翼臻 裴大兵 ZHANG Yi-zhen;PEI Da-bing(Department of Pathology,Affiliated Hospital of Jinggangshan University,Ji'an 343000,China)

机构地区：[1]井冈山大学附属医院病理科,343000 [2]井冈山大学附属医院普外科,343000

出　　处：《中国现代药物应用》2023年第20期53-56,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨肿瘤浸润淋巴细胞(TILs)数量、微卫星不稳定性(MSI)与大肠癌分期的相关性及对预后的评估价值。方法98例大肠癌患者,根据肿瘤分期将Ⅰ期和Ⅱ期设为早期组(58例),Ⅲ期和Ⅳ期设为晚期组(40例)。采用免疫组织化学法检测TILs数量,采用聚合酶链式反应(PCR)检测MSI。比较早期组和晚期组TILs数量和微卫星状态(表达阴性数量),分析TILs数量和微卫星状态与大肠癌分期的相关性。所有患者均进行化疗,根据生存情况分为存活组(82例)和死亡组(16例)。比较存活组和死亡组TILs数量和微卫星状态(表达阴性数量),分析TILs数量和微卫星状态对大肠癌预后的评估价值。结果早期组患者CD4^(+)T淋巴细胞数量(89.18±9.58)%、CD8^(+)T淋巴细胞数量(12.18±2.28)%及微卫星表达阴性数量(2.54±0.28)个均高于晚期组的(43.73±9.15)%、(9.46±2.07)%、(1.48±0.13)个,差异有统计学意义(P<0.05)。Pearson相关性分析显示:大肠癌分期与CD4^(+)和CD8^(+)T淋巴细胞数量及微卫星表达阴性数量呈负相关(r=-0.451、-0.447,-0.487,P<0.05)。存活组患者CD4^(+)T淋巴细胞数量(74.62±10.25)%、CD8^(+)T淋巴细胞数量(11.49±2.17)%及微卫星表达阴性数量(2.21±0.38)个均高于死亡组的(40.17±9.85)%、(8.92±2.27)%、(1.38±0.15)个,差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC)结果显示,CD4^(+)和CD8^(+)T淋巴细胞数量和微卫星表达阴性数量诊断大肠癌预后的曲线下面积(AUC)分别为0.765、0.741和0.730,此时各水平的截断值分别为60.240%、9.157%和1.940个(P<0.05)。结论大肠癌患者TILs数量和MSI会随着患者的病情加重而减少,且这两种指标对大肠癌患者的预后有一定的评估效能。Objective To discuss the correlation of the number of tumor infiltrating lymphocytes(TILs),microsatellite instability(MSI)with staging of colorectal cancer and its prognostic value.Methods A total of 98 patients with colorectal cancer were divided into early group(58 cases,stageⅠandⅡ)and late group(40 cases,stageⅢandⅣ)according to tumor staging.TILs were detected by immunohistochemistry and MSI was detected by polymerase chain reaction(PCR).The number of TILs and microsatellite status(number of negative expression)were compared between the early group and the late group,and the correlation of the number of TILs and microsatellite status and the staging of colorectal cancer was analyzed.All patients received chemotherapy and were divided into survival group(82 cases)and death group(16 cases).The number of TILs and microsatellite status(number of negative expression)were compared between the survival group and the death group,and the value of the number of TILs and microsatellite status for evaluation of prognosis of colorectal cancer was analyzed.Results In the early group,the number of CD4^(+)T lymphocytes was(89.18±9.58)%,the number of CD8^(+)T lymphocytes was(12.18±2.28)%and the number of negative microsatellite expression was(2.54±0.28),which were higher than those of(43.73±9.15)%,(9.46±2.07)%and(1.48±0.13)in the late group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the staging of colorectal cancer was negatively correlated with the number of CD4^(+)and CD8^(+)T lymphocytes and the number of negative microsatellite expression(r=-0.451,-0.447,-0.487;P<0.05).In survival group,the number of CD4^(+)T lymphocytes was(74.62±10.25)%,the number of CD8^(+)T lymphocytes was(11.49±2.17)%,and the number of negative microsatellite expression was(2.21±0.38),which were higher than those of(40.17±9.85)%,(8.92±2.27)%and(1.38±0.15)in the death group,and the differences were statistically significant(P<0.05).Receiver operating characteristic(ROC)curve a

关 键 词：大肠癌 肿瘤浸润淋巴细胞 微卫星不稳定性 分期 预后 

分 类 号：R735.34[医药卫生—肿瘤]