外周血T淋巴细胞亚群水平对结直肠癌患者术后复发的影响及预测价值分析

Analysis of influenced and predictive value of peripheral blood T-lymphocyte subsets on postoperative recurrence in patients with colorectal cancer

摘要:

目的 探讨外周血T淋巴细胞亚群水平对腹腔镜根治术后结直肠癌（CRC）患者术后复发的影响，并分析其预测价值。方法 纳入2016年1月－2017年1月该院行腹腔镜根治术治疗的CRC患者120例，分为复发组（n = 96）和未复发组（n = 24），检测患者术后第１天外周血中CD3⁺、CD4⁺、CD8⁺和CD4⁺/CD8⁺的含量，采用两独立样本t检验分析两组间差异，Logistic回归模型分析各指标与复发的关联，受试者工作特征曲线（ROC）分析其在预测CRC术后复发中的价值。结果 术后复发组CD3⁺、CD4⁺和CD4⁺/CD8⁺水平明显低于未复发组（P < 0.05），CD8⁺水平高于未复发组（P < 0.05）。Logistic回归分析表明，血清中CD8⁺细胞水平（O = 1.14 > 1，95%CI：1.05～1.23）是影响结CRC术后复发的独立危险因素，而CD3⁺（O = 0.82，95%CI：0.75～0.90）、CD4⁺（O = 0.91，95%CI：0.85～0.98）和CD4⁺/CD8⁺（O = 0.20，95%CI：0.06～0.59）是影响CRC术后复发的保护性因素。ROC曲线表明，CD3⁺、CD4⁺、CD8⁺和CD4⁺/CD8⁺水平对术后复发具有一定的预测价值。结论 外周血中CD3⁺、CD4⁺、CD8⁺和CD4⁺/CD8⁺的水平与复发有关，是CRC患者术后复发的独立影响因素，与预后相关，对术后复发具有一定的预测价值。

Abstract:

Objective To investigate the influences of the levels of T-lymphocyte subsets in peripheral blood of patients with colorectal carcinoma after laparoscopic radical resection, and analyze their predictive value for postoperative recurrence.Methods The clinical data were collected from 120 patients with colorectal carcinoma underwent laparoscopic radical resection from January 2016 to January 2017. Detect the levels of CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ after peripheral blood were obtained from 120 patients on the first day postoperatively, and all the patients were divided into two groups according to the presence of recurrence and the immune cells between the two groups were compared with two independent t-test and the influence factors were analyzed with Logistic regression. Finally, ROC curve was used to analyze its value in predicting postoperative recurrence of colorectal carcinoma.Results We found that the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in recrudesce patients were lower than that in non-recrudesce patients (P < 0.05), but the level of CD8⁺ in recrudesce patients were higher than that in non-recrudesce patients (P < 0.05). And Logistic regression analysis found that the CD8⁺ were independent risk factor (O = 1.14 > 1, 95%CI: 1.05～1.23), but the CD3⁺ (O = 0.82, 95%CI: 0.75～0.90), CD4⁺ (O = 0.91, 95%CI: 0.85～0.98), and CD4⁺/CD8⁺ (O = 0.20, 95%CI: 0.06～0.59) were independent protective factors for relapse. ROC curve analysis showed that the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ had certain predictive value for predicting postoperative recurrence.Conclusion Levels of CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ are associated with recurrence, and independent prognostic influencing factors for postoperative patients with colorectal carcinoma, it has a certain value in predicting postoperative recurrence of patients.