鼻咽癌同步放化疗治疗进程中免疫微环境变化及其与预后的关系  

Changes of immune microenvironment and its relationship with prognosis during concurrent radiotherapy and chemotherapy for nasopharyngeal carcinoma

作　　者：裴玉 唐春慧 PEI Yu;TANG Chunhui(Department of Oncology,Xiangyang Central Hospital,Xiangyang 441100,China)

机构地区：[1]襄阳市中心医院肿瘤科,襄阳441100

出　　处：《中国免疫学杂志》2025年第4期931-937,共7页Chinese Journal of Immunology

摘　　要：目的:探讨鼻咽癌患者同步放化疗治疗中免疫微环境变化与预后的相关性。方法:选取134例进行同步放化疗治疗的鼻咽癌患者,免疫组化法分析肿瘤组织芯片中6种免疫细胞特异性标志物表达水平,并将其分为高表达组和低表达组,分析6种免疫组化指标与患者临床病理特征的相关性。依据患者预后情况分为预后不良组(n=41)和预后良好组(n=93),通过Logistic回归模型进行多因素分析,构建列线图预测模型,并对模型进行验证。采用Kaplan-Meier法和Log-rank检验分析6种免疫组化指标表达水平对患者五年生存率的影响。结果:同步放化疗治疗后,患者肿瘤组织中CD3、CD4、CD8、CD56的表达水平明显升高,CD10及FOXP3的平均阳性率较治疗前明显降低(P<0.05)。CD3、CD4、CD8和CD56的表达水平与肿瘤大小、淋巴结转移呈负相关(P<0.05);CD10和FOXP3的表达水平与肿瘤大小、淋巴结转移呈正相关(P<0.05)。肿瘤大小、淋巴结转移、CD10、FOXP3是影响鼻咽癌患者预后情况的独立危险因素(P<0.05),CD3、CD4、CD8、CD56是保护因素(P<0.05)。CD3、CD4、CD8和CD56表达水平较高,CD10和FOXP3表达水平较低的患者五年生存率较高(P<0.001)。结论:同步放化疗治疗后,CD3、CD4、CD8、CD56的平均阳性率较治疗前明显增加,CD10及FOXP3的平均阳性率较治疗前明显降低,结合患者临床特征构建的预测模型可有效预测鼻咽癌患者的预后情况。Objective:To investigate the relationship between the changes of immune microenvironment and prognosis in nasopharyngeal carcinoma patients undergoing concurrent radiotherapy and chemotherapy.Methods:A total of 134 patients with nasopharyngeal carcinoma who were treated with concurrent radiotherapy and chemotherapy were selected to analyze the expression levels of six immune cell markers in tumor tissue microarray by immunohistochemistry.They were divided into high expression group and low expression group,and the correlation between six kinds of immunohistochemical indicators and the clinical pathological characteristics of patients were analyzed.According to the prognosis of patients,they were divided into poor prognosis group(n=41)and good prognosis group(n=93).Multifactor analysis was conducted through Logistic regression model to construct nomogram prediction model and verify the model.Kaplan-Meier method and Log-rank test were used to analyze the influence of the expression levels of six immunohistochemical indicators on the five-year survival rate of patients.Results:After concurrent radiotherapy and chemotherapy,the expression levels of CD3,CD4,CD8 and CD56 in tumor tissues of patients were increased significantly,and the average positive rates of CD10 and FOXP3 were significantly lower than those before treatment(P<0.05).The expression levels of CD3,CD4,CD8 and CD56 were negatively correlated with tumor size and lymph node metastasis(P<0.05);the expression levels of CD10 and FOXP3 were positively correlated with tumor size and lymph node metastasis(P<0.05).Tumor size,lymph node metastasis,CD10 and FOXP3 were independent risk factors affecting the prognosis of patients with nasopharyngeal carcinoma(P<0.05),while CD3,CD4,CD8 and CD56 were protective factors(P<0.05).Patients with higher expression levels of CD3,CD4,CD8 and CD56 and lower expression levels of CD10 and FOXP3 have higher five-year survival rates.Conclusion:After concurrent radiotherapy and chemotherapy,the average positive rates of CD3,CD4,CD8

关 键 词：鼻咽癌 放疗 化疗 免疫细胞 肿瘤微环境 预后 

分 类 号：R499[医药卫生—康复医学]