老年Ⅱb-Ⅲ期结直肠癌根治术患者T淋巴细胞亚群的影响因素分析  

Analysis of influencing factors on T lymphocyte subsets in elderly patients with stageⅡb-Ⅲcolorectal cancer undergoing radical surgery

作　　者：李侨 陈江 刘柄 姜黎 LI Qiao;CHEN Jiang;LIU Bing;JIANG Li(Department of Laboratory Medicine,Yibin Hospital of Traditional Chinese Medicine,644000 Yibin,Sichuan,China;Department of Laboratory Medicine,Changning County Hospital of Traditional Chinese Medicine,644300 Yibin,Sichuan,China;Department of Laboratory Medicine,People's Hospital of Pidu District,611530 Chengdu,Sichuan,China)

机构地区：[1]宜宾市中医医院检验科,四川宜宾644000 [2]宜宾市长宁县中医院检验科,四川宜宾644300 [3]郸都区人民医院检验科,四川成都611530

出　　处：《临床消化病杂志》2024年第6期390-394,共5页Chinese Journal of Clinical Gastroenterology

基　　金：2018年成都市医学科研课题(No:2018013)。

摘　　要：[目的]研究老年结直肠癌根治术患者T淋巴细胞亚群变化的影响因素,以期为临床诊治提供参考。[方法]入选经病理确诊的老年结直肠癌根治术患者400例,监测其围手术期T淋巴细胞亚群变化,并与同期来院参加体检的健康体检者(对照组)进行对比。应用单因素分析随访期间T淋巴细胞亚群变化差异,并采用多因素Logistic分析对上述有差异的统计学资料进行进一步回归分析,最终探讨影响T淋巴细胞亚群变化的相关因素。[结果]老年结直肠癌组患者术前、术后1周外周血CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)水平均显著低于对照组,且根治术后1周外周血CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)水平较术前有显著升高,均差异有统计学意义(P<0.05)。单因素分析显示,性别、肿瘤部位、是否术后化疗、淋巴结清扫情况、合并高血压相比T淋巴细胞亚群变化差异无统计学意义(P>0.05),而临床分期,肿瘤低分化,合并糖尿病,淋巴结转移患者T淋巴细胞亚群变化差异较大(P<0.05)。将上述有差异的单因素分析纳入多因素分析显示,临床分期、低分化及淋巴结转移为影响T淋巴细胞亚群变化的危险因素。[结论]老年结直肠癌根治术患者T淋巴细胞亚群变化的影响因素包括临床分期、分化程度、淋巴结转移。[Objective]To study the influencing factors of the changes of T lymphocyte subsets in elderly patients undergoing radical resection of colorectal cancer,in order to provide references for clinical diagnosis and treatment..[Methods]A total of 400 elderly patients diagnosed by pathology after radical resection of colorectal cancer were selected to monitor the changes of T lymphocyte subsets during perioperative period,and compared with healthy subjects(control group)who came to the hospital for physical examination during the same period.All patients were pathologically diagnosed and the changes in T lymphocyte subsets during the perioperative period were monitored and compared with those who came to the hospital for physical examination during the same period(control group).Univariate analysis was used to analyze the changes of T lymphocyte subsets during the follow-up period,and multivariate Logistic analysis was used for further regression analysis of the above-mentioned statistical data with differences,and finally to explore the relevant factors affecting the changes of T lymphocyte subsets.[Results]The levels of peripheral blood CD3+,CD4+,and CD4+/CD8+ in the elderly colorectal cancer group were significantly lower than those in the control group before and 1 week after surgery,and the levels of CD3+,CD4+ and CD4+/CD8+ in peripheral blood were higher than those in the control group at 1 week after radical surgery.There was a significant increase in the former,and the differences were statistically significant(P<0.05).Univariate analysis showed that there was no significant difference in gender,tumor location,postoperative chemotherapy,lymph node dissection,and hypertension compared with T lymphocyte subsets(P>0.05),while clinical staging,poorly differentiated tumors,and diabetes.The changes of T lymphocyte subsets in patients with lymph node metastasis were highly different(P<0.05).Incorporating the above-mentioned differential single factor analysis into a multivariate analysis showed that clinical staging,p

关 键 词：结直肠癌 T淋巴细胞亚群 多因素LOGISTIC分析 

分 类 号：R735.3[医药卫生—肿瘤]