直肠癌患者外周血淋巴细胞亚群与新辅助治疗效果的关系  被引量:1

Relationship between peripheral blood lymphocyte subsets and neoadjuvant therapy efficacy in patients with colorectal cancer

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作  者:陈颖秀 卢仁泉 郭林 郑慧 Chen Yingxiu;Lu Renquan;Guo Lin;Zheng Hui(Departmentof Clinical Laboratory,FudanUniversity Shanghai Cancer Center(Xiamen Branch),Xiamen 361022,China;Departmentof Clinical Laboratory,Fudan University Shanghai Cancer Center,Shanghai200032,China)

机构地区:[1]复旦大学附属肿瘤医院厦门医院检验科,厦门361022 [2]复旦大学附属肿瘤医院检验科,上海200032

出  处:《中华检验医学杂志》2024年第12期1419-1425,共7页Chinese Journal of Laboratory Medicine

摘  要:目的探讨直肠癌新辅助治疗对患者外周血淋巴细胞亚群绝对数和百分比的影响, 及淋巴细胞亚群与新辅助治疗效果的关系。方法回顾性分析2020年1月1日至2023年12月31日就诊于复旦大学附属肿瘤医院的局部晚期直肠癌患者外周血淋巴细胞亚群检测结果。入组患者均进行术前新辅助治疗[短程放疗序贯PD-1(程序性死亡受体1)单抗联合Xelox化疗4个疗程], 在治疗前和新辅助治疗结束后都采用流式细胞术检测外周血中淋巴细胞各亚群(CD3^(+)T、CD4^(+)T、CD8^(+)T、B、NK)的绝对数和比例(%)以及CD4^(+)CD25^(+)CD127^(low)调节性T细胞(Treg)占CD4^(+)T细胞的百分比(CD4^(+)Treg%)、功能性CD8^(+)T占总T细胞的百分比(CD8^(+)CD28^(+)T%)。根据上述条件共有58例患者符合要求, 并在完成新辅助治疗后, 根据临床或病理诊断进行疗效判断, 分为完全缓解(CR)组和非CR组, CR组男20例, 女7例, 年龄(52.89±9.95)岁;非CR组男17例, 女14例, 年龄(57.26±11.05)岁。采用配对t检验比较分析淋巴细胞各亚群在新辅助治疗前后的变化, 通过两样本独立t检验分析CR组和非CR组各淋巴细胞亚群治疗后变化程度和治疗前基础水平的差异, 并通过受试者工作特征(ROC)曲线评估相关亚群的基础水平对直肠癌患者新辅助治疗疗效的预测效能。把应用相同治疗方案但仅有治疗前淋巴细胞各亚群基础水平的患者(n=104)作为验证组, 分析相关预测指标的符合率。结果与新辅助治疗前比较, 治疗后所有患者CD3^(+)T、CD4^(+)T、CD8^(+)T、B、NK细胞绝对数均减少(P<0.05), CD8^(+)T%和NK%均升高(P<0.05), B%下降(P<0.05), CD3^(+)T%、CD4^(+)T%、CD4^(+)Treg%和CD8^(+)CD28^(+)T%差异无统计学意义, 上述变化与疗效无关, 但CR组患者新辅助治疗前CD3^(+)T、CD4^(+)T、CD8^(+)T绝对数, CD3^(+)T%、CD8^(+)T%以及CD8^(+)CD28^(+)T%高于非CR组患者(P<0.05)。ROC曲线分析显示, 上述疗效相关指标治疗前基础Objective:To investigate the impact of neoadjuvant therapy on the absolute counts and percentages of peripheral blood lymphocyte subsets in rectal cancerpatientsand examine the relationship between the efficacy of neoadjuvant therapy and lymphocyte subsets.Methods:A retrospective analysis was conducted on locally advanced rectal cancer patients treated at Fudan University Shanghai Cancer Center from January 1,2020 to December 31,2023.All enrolled patients received preoperative neoadjuvant therapy[short-course radiotherapy followed by four cycles of PD-1(programmed cell death protein 1)monoclonal antibody combined with Xelox chemotherapy].Flow cytometry was used before and after neoadjuvant therapy to assess the absolute counts and percentages of peripheral blood lymphocyte subsets,including CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,B cells,NK cells,as well as the percentage of CD4^(+)CD25^(+)CD127^(low) regulatory T cells within CD4^(+)T cells(CD4^(+)Treg%)and the percentage offunctional CD8^(+)T cells withintotalTcells(CD8^(+)CD28^(+)T%).Based on these criteria,58 patients were eligible for the study.Following neoadjuvant therapy,therapeutic efficacy was evaluated through clinical and pathological diagnosis,classifying patients intoa complete response(CR)group(including clinical complete response and pathologic complete response)and non-CR group.The CR group consisted of 20males and 7 females(mean age 52.89±9.95 years),while the non-CR group included 17males and 14 females(mean age 57.26±11.05 years).Paired t-test were used to compare changes in lymphocyte subsets before and after neoadjuvant therapy,and independent two-sample-t-tests were applied to analyze the differences in post-treatment changes and the basal levels of lymphocyte subsets between CR group and non-CR group.Receiver operating characteristic(ROC)curve were employed to evaluate the predictive performance of baseline lymphocyte subsets for the efficacy of neoadjuvant therapy in rectal cancer patients.A validation cohort(n=104)with only baseli

关 键 词:直肠癌 新辅助治疗 淋巴细胞亚群 疗效预测 

分 类 号:R735.37[医药卫生—肿瘤]

 

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