宫颈癌患者自身免疫功能、肿瘤标志物水平对癌肿根治术后复发的影响  

Effects of autoimmune function and tumor markers on recurrence after radical operation in patients with cervical cancer

作　　者：克热曼·牙库甫[1] 玛丽亚木古丽·克依木 韩涛[1] 苏莱娅·胡赛音[1] Kereman Yakufu;Maliyamuguli Keyimu;Han Tao;Sulaiya Husaiyin(Gynecological Medical Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院妇科医学诊疗中心/新疆宫颈癌防治临床医学研究中心,乌鲁木齐830001

出　　处：《疑难病杂志》2024年第7期793-797,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金项目(2021D01C194)。

摘　　要：目的探讨宫颈癌患者自身免疫功能、肿瘤标志物水平对癌肿根治术后复发的影响。方法选择2021年1月—2022年11月新疆维吾尔自治区人民医院妇科诊治的宫颈癌患者108例作为研究对象。患者均接受宫颈癌根治术,根据治疗后1年内肿瘤复发转移情况分为未复发组(n=86)和复发组(n=22)。比较2组患者临床资料、宫颈癌疾病特征、自身免疫功能及肿瘤标志物的差异;Spearman相关性分析及多因素Logistic回归分析筛选宫颈癌患者肿瘤复发的危险因素;受试者工作特征(ROC)曲线评估各危险因素对宫颈癌患者术后复发的预测价值。结果复发组患者脉管癌栓及深肌层浸润比例高于未复发组(χ^(2)/P=4.923/0.027、4.284/0.038);复发组患者CD4^(+)/CD8^(+)T细胞比值、NK细胞比例均低于未复发组,全身免疫炎性指数(SII)水平高于未复发组(t/P=4.117/<0.001、2.680/0.009、3.709/<0.001);CA125及CA199水平均高于未复发组(t/P=2.040/0.044、2.586/0.011);Spearman相关性分析及多因素Logistic回归分析发现宫颈癌患者CD4^(+)/CD8^(+)比值高、NK细胞比例高是术后复发的保护因素[OR(95%CI)=0.019(0.010~0.048)、0.621(0.453~0.852)],SII、CA125水平高均是术后复发的危险因素[OR(95%CI)=1.080(1.003~1.160)、1.042(1.009~1.076)];CD4^(+)/CD8^(+)比值、NK细胞比例、SII、CA125及四项指标联合预测宫颈癌患者术后复发的曲线下面积分别为0.757、0.682、0.730、0.661、0.914,四项联合优于各自单独预测效能(Z/P=4.234/<0.001、5.113/<0.001、4.512/<0.001、5.452/<0.001)。结论宫颈癌患者根治术后免疫功能较差、肿瘤标志物水平较高均提示患者存在复发风险,持续监测宫颈癌根治术后患者的免疫功能并及时干预可在一定程度上避免术后肿瘤复发,进而改善患者的预后。Objective To investigate the effects of autoimmune function and tumor markers on recurrence after radical resection in patients with cervical cancer.Methods We conducted a study involving 108 patients diagnosed with cervical cancer who received treatment at our hospital between January 2021 and November 2022.All patients underwent radical resection for cervical cancer.Based on the occurrence of recurrence and metastasis within 1 year after treatment initiation,the patients were categorized into two groups:non-recurrent group(n=86)and recurrent group(n=22).The differences of clinical data,disease characteristics,autoimmune function and tumor markers of cervical cancer between the two groups were compared.Spearman correlation analysis and multivariate logistic regression analysis were employed to identify the risk factors for tumor recurrence in patients with cervical cancer.Furthermore,the predictive value of these risk factors in postoperative recurrence of cervical cancer was evaluated using receiver operating characteristic curve(ROC)analysis.Results In the recurring cohort,there was a notable increase in the proportion of patients displaying vascular tumor thrombus and deep muscular invasion(χ^(2)/P=4.923/0.027,4/284/0.038).Additionally,there was a significant decrease in the average CD4^(+)T/CD8^(+)T ratio and the proportion of NK cells(t/P=4.117/<0.001,2.680/0.009,3.708/<0.001).Conversely,the average SII level and the average CA125 and CA199 levels were markedly elevated(t/P=2.040/0.044,2.586/0.011).Through Spearman correlation analysis and multivariate Logistic regression analysis,it was determined that a lower CD4^(+)T/CD8^(+)T ratio,NK cell ratio,and higher SII and CA125 levels were identified as risk factors for postoperative recurrence in cervical cancer patients[OR(95%CI)=0.019(0.010-0.048),0.621(0.453-0.852),1.080(1.003-1.160),1.042(1.009-1.076)].Moreover,ROC analysis demonstrated that the CD4^(+)T/CD8^(+)T ratio,NK cell ratio,SII,and CA125 independently and collectively provided higher predictive va

关 键 词：宫颈癌 癌肿根治术 免疫功能 肿瘤标志物 复发 

分 类 号：R737.33[医药卫生—肿瘤]