外周血CD8+T淋巴细胞水平和CTC表达对Ⅲ期结直肠癌根治性术后辅助放化疗患者预后的影响

doi:10.3969/j.issn.1007-3205.2024.03.006

河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (3): 284-288.doi: 10.3969/j.issn.1007-3205.2024.03.006

外周血CD8+T淋巴细胞水平和CTC表达对Ⅲ期结直肠癌根治性术后辅助放化疗患者预后的影响

河北中石油中心医院肿瘤科，河北廊坊 065000

出版日期:2024-03-25 发布日期:2024-04-07
作者简介:熊露宁（1982-），女，湖北孝感人，河北中石油中心医院副主任护师，医学学士，从事肿瘤疾病护理研究。
基金资助:
河北省廊坊市科学技术研究与发展计划项目（2021013038）

Effect of peripheral blood CD8+ T lymphocyte level and CTC expression on the prognosis of stage Ⅲ colorectal cancer patients undergoing adjuvant radiochemotherapy after radical surgery

Department of Oncology, China Petroleum Central Hospital, Hebei Province, Langfang 065000, China

Online:2024-03-25 Published:2024-04-07

摘要/Abstract

摘要： 目的探究外周血群集分化8阳性细胞(cluster of differentiation 8-positive cells，CD8+)T淋巴细胞水平和循环肿瘤细胞（circulating tumor cell，CTC）表达对Ⅲ期结直肠癌根治性术后辅助放化疗患者预后的影响。
方法选取我院进行治疗的Ⅲ期结直肠癌根治性术后辅助放化疗患者156例作为本次研究对象，对患者进行为期6个月的随访，根据患者在随访期内是否复发进行分组：未复发组112例，复发组44例，对患者术后1 d的T淋巴细胞亚群水平进行检测，并对其CTC表达水平进行检测，探究CTC表达阳性率与患者临床病理特征间的关系，并探究上述指标对患者预后的预测价值。
结果与未复发组相比，复发组CD3+、CD4+ 、CD4+/CD8+水平较低，但CD8+水平较高（P＜0.05）。测定患者外周血中CTC表达情况，未复发组CTC计数为（2.56±0.87）个，复发组CTC计数为（6.68±2.74）个，差异有统计学意义（t=9.782，P＜0.05）。患者CTC表达与患者的性别、年龄、淋巴结是否转移、组织分化程度无关（P＞0.05）。采用ROC曲线分析T淋巴细胞亚群水平及CTC表达对患者复发的预测价值，CD3+、CD4+ 、CD8+ 、CD4+/CD8+及CTC表达对患者术后复发曲线下面积（area under the curve，AUC）分别为0.852、0.703、0.712、0.747、0.920，对上述指标联合应用对患者的复发情况进行预测，其AUC值为0.954。
结论患者的CD3+、CD4+ 、CD4+/CD8+低表达，CD8+及CTC高表达会增加Ⅲ期结直肠癌根治性术后辅助放化疗患者术后复发概率，且各指标联合检测对患者预后结局具有一定预测价值。

关键词: 结直肠肿瘤, CD8+T淋巴细胞, 循环肿瘤细胞

Abstract: Objective To explore the effect of peripheral blood cluster of differentiation 8-positive cells （CD8+） T lymphocyte level and expression of circulating tumor cells (CTC) on the prognosis of stage Ⅲ colorectal cancer (CRC)patients undergoing adjuvant radiochemotherapy after radical surgery.
Methods We selected 156 CRC patients undergoing adjuvant radiochemotherapy after radical surgery in our hospital as research subjects. They were followed up for 6 months.According to presence of recurrence during the follow-up period, they were divided into non-rercurrence group (n=112) and recurrence group (n=44). T lymphocyte subsetlevel and CTC expression levels were detected in patients at 1 d after surgery, to explore the relationship between the positive rate of CTC expression and the clinicopathological characteristics of patients, and to investigate the predictive value of the above indicators for prognosis of patients.
Results Compared with non-recurrence group, recurrence group had lower CD3+, CD4+, and CD4+/CD8+ levels, but higher CD8+ levels (P＜0.05). CTC expression in the peripheral blood of patients was determined, and CTC count was (2.56±0.87) in non-recurrence group and (6.68±2.74) in recurrence group, suggesting significant differences (t=9.782, P＜0.05). CTC expression of patients was not related to gender, age, lymph node metastasis, or degree of tissue differentiation of patients (P＞0.05). Receiver operating characteristic (ROC) curve was used to analyze the predictive value of T lymphocyte subset levels and CTC expression for recurrence, and the area under the curve (AUC) of CD3+, CD4+, CD8+, CD4+/CD8+ and CTC expression was 0.852, 0.703, 0.712, 0.747, and 0.920, respectively. The AUC of the combined application of the above indexes in predicting the recurrence of the patients was 0.954.
Conclusion Low expression of CD3+, CD4+, CD4+/CD8+, and high expression of CD8+ and CTC in patients with stage Ⅲ CRC undergoing adjuvant chemoradiotherapy after radical surgery will increase the postoperative recurrence rate, and the combined detection of all indicators has certain predictive value for the prognosis of patients.

Key words: colorectal neoplasms, CD8+ T lymphocytes, circulating tumor cells

熊露宁, 董久兴, 赵佳, 任继勇, 刘军. 外周血CD8+T淋巴细胞水平和CTC表达对Ⅲ期结直肠癌根治性术后辅助放化疗患者预后的影响 [J]. 河北医科大学学报, 2024, 45(3): 284-288.

XIONG Lu-ning, DONG Jiu-xing, ZHAO Jia, REN Ji-yong, LIU Jun. Effect of peripheral blood CD8+ T lymphocyte level and CTC expression on the prognosis of stage Ⅲ colorectal cancer patients undergoing adjuvant radiochemotherapy after radical surgery[J]. Journal of Hebei Medical University, 2024, 45(3): 284-288.

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外周血CD8+T淋巴细胞水平和CTC表达对Ⅲ期结直肠癌根治性术后辅助放化疗患者预后的影响

Effect of peripheral blood CD8+ T lymphocyte level and CTC expression on the prognosis of stage Ⅲ colorectal cancer patients undergoing adjuvant radiochemotherapy after radical surgery

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