外周血T细胞和肿瘤指标对晚期、复发宫颈癌免疫治疗疗效及预后的评价  

Evaluation of Immunotherapy Efficacy and Prognosis in Advanced and Recurrent Cervical Cancer Using Peripheral Blood T Cells and Tumor Markers

作　　者：崔晓丽 武文丽[3] 隋磊 栾朝辉 孙丽 Cui Xiaoli;Wu Wenli;Sui Lei;Luan Zhaohui;Sun Li(Shandong Second Medical University,Weifang,Shandong 261042,China;Department of Gynecology,Pingdu People's Hospital,Qingdao,Shandong 266700,China;Department of Gynecology,Peking University First Hospital,Beijing 100032,China;First Department of Gynecologic Oncology,Qingdao Central Hospital of Rehabilitation University,Qingdao,Shandong 266000,China)

机构地区：[1]山东第二医科大学,山东潍坊261042 [2]平度市人民医院妇科,山东青岛266700 [3]北京大学第一医院妇科,北京100032 [4]康复大学青岛中心医院妇瘤一科,山东青岛266000

出　　处：《青岛医药卫生》2024年第6期456-462,共7页Qingdao Medical Journal

基　　金：山东省医药卫生科技发展计划项目(2016WS0562);山东省重点研发计划项目(2018GSF118238)。

摘　　要：目的 通过检测外周血T淋巴细胞亚群和肿瘤标记物指标在晚期、复发宫颈癌免疫治疗前后的变化,评估其与疗效及预后的相关性。方法 前瞻性纳入2022年08月—2024年08月期间在康复大学附属青岛中心医院及合作医院接受一线免疫治疗联合放化疗的晚期、复发宫颈癌患者50例,检测患者治疗前基线水平及治疗后1个周期T淋巴细胞亚群及其程序性死亡受体-1(Programmed death receptor-1,PD-1)表达率,联合肿瘤标记物鳞状细胞癌抗原(squamous-cell carcinoma antigen, SCC)、糖类抗原125(Carbohydrate antigen 125,CA125),采用Logistic回归分析疗效的影响因素,Cox回归探究预后的影响因素。结果 Logistic回归表明基线CD4^(+)T细胞百分比和治疗1个周期后CD8+T细胞百分比、CA125及SCC、CD4^(+)PD-1及CD8+PD-1表达率是疗效的影响因素(P<0.05)。Cox回归分析显示基线CD4^(+)T细胞百分比和治疗1个周期后CD4^(+)T细胞及CD8+T细胞百分比、CD4^(+)及CD8+PD-1表达率、CA125及SCC是预后的影响因素。结论 基线高水平CD4^(+)T细胞百分比和治疗1个周期后高水平CD4^(+)T细胞、CD8+T细胞百分比及其PD-1表达率,低水平CA125及SCC可能是患者从免疫治疗中获益的有利因素。Objective By examining the changes of peripheral blood T lymphocyte subsets and tumor markers indexes before and after immunotherapy for advanced and recurrent cervical cancer,the correlation with therapeutic effect and prognosis was evaluated.Methods Fifty patients with advanced and recurrent cervical cancer who received first-line immunotherapy combined with chemoradiotherapy in Qingdao Central Hospital and partner hospitals from August 2022 to August 2024 were prospectively included.Detect the baseline level of patients before treatment and the expression rate of T lymphocyte subsets and Programmed death receptor-1(PD-1)in 1 cycle after treatment.Combined with tumor markers squamous cell carcinoma antigen(SCC)and Carbohydrate antigen 125(CA125),the influencing factors of efficacy were analyzed by Logistic re-gression.Cox regression was used to investigate the prognostic factors.Results Logistic regres-sion showed that baseline CD4^(+)T cell percentage,CD8+T cell percentage,CA125 and SCC,CD4^(+)PD-1 and CD8+PD-1 expression rate after 1 cycle of treatment were the influencing factors of curative effect(P<0.05).Cox regression analysis showed that the percentage of baseline CD4^(+)T cells,the percentage of CD4^(+)T cells and CD8+T cells,the expression rate of CD4^(+)and CD8+PD-1,CA125 and SCC were prognostic factors.Conclusion The high percentage of CD4^(+)T cells at baseline,the high percentage of CD4^(+)T cells and CD8+T cells,the low expression rate of CD4^(+)PD-1 and CD8+PD-1,and the low level of CA125 and SCC after 1 cycle of treatment may be favorable factors for patients to benefit from immunotherapy.

关 键 词：晚期复发宫颈癌 T细胞亚群 疗效 预后 

分 类 号：R737.33[医药卫生—肿瘤]