食管癌患者外周血TCR多样性参数检测及与临床预后的相关性分析  

Detection of TCR diversity parameters in peripheral blood of patients with esophageal cancer and correlation analysis with clinical prognosis

作　　者：曹睿 丁旭青[1] 倪渐凤[2] 王聪 吕明闯[1] 陈基升 张印[1] 闫付庆 Cao Rui;Ding Xu-qing;Ni Jian-feng;Wang Cong;Lv Ming-chuang;Chen Ji-sheng;Zhang Yin;Yan Fu-qing(Department of Thoracic Surgery,The Second People''s Hospital of Nanyang,Nanyang 473000,Henan,China;Laboratory of Biological Immunization,Nanyang Second Generasl Hospital,Nanyang 473000,Henan,China;Department of Pharmacy,Nanyang Second Generasl Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第二人民医院胸外科,河南南阳473000 [2]南阳市第二人民医院生物免疫实验室,河南南阳473000 [3]南阳市第二人民医院药学科,河南南阳473000

出　　处：《四川生理科学杂志》2025年第2期446-449,共4页

摘　　要：目的:分析食管癌(Esophageal cancer,EC)患者外周血T细胞受体(T cell receptor,TCR)多样性参数及其与患者临床预后的相关性。方法:选取2021年4月至2023年5月期间本院胸外科收治的126例行胸腔镜手术治疗的EC患者作为研究对象。手术后,患者均随访1 y。根据患者术后预后情况不同将患者分为预后良好组与预后不良组。术前测定其外周血TCR多样性参数,根据TCR多样性参数D50量化评估患者免疫状况。分析两组的免疫力状况与其预后的关系。结果:126例EC患者4例失访;122例患者中28例预后不良,占22.95%。预后不良组术前CD4^(+)/CD8^(+)显著低于预后良好组,CD8^(+)显著低于预后良好组,免疫力状况显著差于预后良好组(P<0.05)。经Cox回归分析显示,CD4^(+)/CD8^(+)降低、免疫力中及免疫力差均是EC患者术后预后不良的影响因素(P<0.05)。绘制受试者工作特征(Receiver operating characteristic,ROC)曲线,结果显示,TCR多样性参数D50、CD4^(+)/CD8^(+)单独及联合预测EC患者预后不良的曲线下面积分别为0.677、0.766、0.810。结论:TCR多样性参数D50与EC患者预后密切相关,但预测EC患者术后预后不良时仍需结合其他指标联合评估。Objective:To analyze the diversity parameters of peripheral blood T cell receptor(TCR)in patients with Esophageal cancer(EC)and their correlation with clinical prognosis.Methods:126 EC patients who underwent thoracoscopic surgery in the Department of Thoracic Surgery of our hospital from April 2021 to May 2023 were selected as the study objects.All patients were followed up for 1 year after surgery.According to the different postoperative prognosis,the patients were divided into good prognosis group and bad prognosis group.Preoperative TCR diversity parameters in peripheral blood were measured,and the immune status of patients was quantitatively assessed according to TCR diversity parameter D50.The relationship between immune status and prognosis of the two groups was analyzed.Results:Of 126 EC patients,4 cases were lost to follow-up.Among 122 patients,28 had poor prognosis(22.95%).Preoperative CD4^(+)/CD8^(+)in the poor prognosis group was significantly lower than that in the good prognosis group,CD8^(+)was significantly lower than that in the good prognosis group,and the immunity status was significantly worse than that in the good prognosis group(P<0.05).Cox regression analysis showed that decreased CD4^(+)/CD8^(+),moderate immunity and poor immunity were all factors affecting the postoperative prognosis of EC patients(P<0.05).The Receiver operating characteristic(ROC)curve was drawn,and the results showed that the area under the curve of TCR diversity parameters D50 and CD4^(+)/CD8^(+)alone and in combination predicted the poor prognosis of EC patients were 0.677,0.766 and 0.810,respectively.Conclusion:The TCR diversity parameter D50 is closely related to the prognosis of EC patients,but it still needs to be combined with other indicators to predict the poor prognosis of EC patients.

关 键 词：食管癌 T细胞受体多样性参数D50 临床预后 

分 类 号：R73[医药卫生—肿瘤]