分化型甲状腺癌患者术后^(131)I治疗前细胞免疫状态与临床病理特征的相关性研究  

POSTOPERATIVE RELATIONSHIP BETWEEN CELLULAR IMMUNE STATUS AND CLINICOPATHOLOGICAL CHARACTERISTICS IN DIFFERENTIATED THYROID CANCER PRIOR TO 131 I THERAPY

作　　者：卢承慧 李娇[1] 刘新峰[1] 王国强[1] 王增华 张莹莹[1] 韩娜[1] 司增梅 王叙馥[1,2] LU Chenghui;LI Jiao;LIU Xinfeng;WANG Guoqiang;WANG Zenghua;ZHANG Yingying;HAN Na;SI Zengmei;WANG Xufu(Department of Nuclear Medicine,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院核医学科,山东青岛266003 [2]卫生部核医学重点实验室

出　　处：《精准医学杂志》2023年第6期499-502,共4页Journal of Precision Medicine

基　　金：卫生部核医学重点实验室、江苏省分子核医学重点实验室开放课题(KF201903)。

摘　　要：目的探讨分化型甲状腺癌(differentiated thyroid carcinomar,DTC)患者术后^(131)I治疗前细胞免疫状态与肿瘤临床病理特征的关系。方法回顾性分析2018年3月-2019年2月在我院接受过甲状腺全切除术及颈部淋巴结清扫术的DTC患者155例,所有患者术后1~3个月均行^(131)I治疗,且在^(131)I治疗前1 d检测外周血自然杀伤(NK)细胞和T细胞亚群(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD4/CD8比值)水平。采用单因素分析比较不同临床病理特征患者各细胞免疫指标差异。结果男性组患者外周血CD4^(+)T细胞水平显著低于女性组(t=-2.120,P<0.05);年龄≥55岁组患者外周血NK细胞水平显著高于<55岁组,CD3^(+)T细胞与CD8^(+)T细胞水平显著低于<55岁组(z=-2.344、-2.681,t=2.266,P<0.05);肿瘤最大径>2 cm组患者的外周血CD3^(+)T细胞、CD4^(+)T细胞水平及CD4/CD8比值低于≤2 cm组(z=2.595、-2.652,t=3.861,P<0.05);而M1组患者的外周血CD4^(+)T细胞水平低于M0组(t=4.035,P<0.05)。结论DTC患者术后^(131)I治疗前患者的细胞免疫状态与肿瘤的临床病理特征存在一定相关性,外周血CD4^(+)T细胞水平在男性、肿瘤最大径>2 cm、M1分期的患者中显著降低,监测淋巴细胞亚群有助于临床从免疫角度对患者进行诊疗干预。Objective To investigate the postoperative relationship between cellular immune status and clinicopathological features in patients with differentiated thyroid carcinoma(DTC)before ^(131)I therapy.Methods We retrospectively included 155 patients with DTC who had undergone total thyroidectomy with neck lymph node dissection plus ^(131)I treatment 1-3 months after the operation in our hospital from March 2018 to February 2019.Peripheral blood natural killer(NK)cells and T cell subsets(CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,and CD4/CD8 ratio)were measured 1 d before ^(131)I therapy.Univariable analysis was used to compare the cellular immunity indicators between patients with different clinicopathological features.Results The level of peripheral blood CD4^(+)T cells in male patients was significantly lower than that in female patients(t=-2.120,P<0.05).The patients aged≥55 years showed a significantly higher level of NK cells and significantly lower levels of CD3^(+)T cells and CD8^(+)T compared with those aged<55 years(z=-2.344,-2.681,t=2.266,P<0.05).The levels of CD3^(+)T cells,CD4^(+)T cells,and CD4/CD8 were significantly lower in the patients with maximum tumor diameter>2 cm than in those with maximum tumor dia-meter≤2 cm(z=2.595,-2.652,t=3.861,P<0.05).The level of CD4^(+)T cells in the M1 group was significantly lower than that in the M0 group(t=4.035,P<0.05).Conclusion The cellular immune status is associated with the clinicopathological features of patients with DTC after surgery and before ^(131)I therapy,with significantly decreased levels of peripheral blood CD4^(+)T cells for males,maximum tumor diameter>2 cm,and M1 stage.Monitoring lymphocyte subsets can help guide interventions for patients from the immune perspective.

关 键 词：甲状腺肿瘤 免疫 细胞 影响因素分析 肿瘤分期 碘放射性同位素 

分 类 号：R736.1[医药卫生—肿瘤]