术前T淋巴细胞亚群、癌胚抗原水平与直肠癌患者预后相关性研究
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摘要
目的探讨直肠癌患者术前外周血中T淋巴细胞亚群、癌胚抗原(CEA)水平与直肠癌患者预后的关系。方法回顾性收集2012年1月至2013年4月于该院住院并行直肠癌根治术92例患者的临床病理资料,并通过电话、微信、邮件及调阅患者再入院资料,随访了解患者术后情况,分析术前外周血T淋巴细胞亚群、CEA与直肠癌临床病理特征及预后的关系。结果单因素分析结果显示,CEA与肿瘤浸润深度、淋巴结转移、病理类型、脉管浸润、TNM分期有关(P<0.05),T淋巴细胞亚群与肿瘤浸润深度、神经浸润、TNM分期有关(P<0.05)。CEA阳性组5年生存率低于其阴性组,T淋巴细胞亚群阳性组5年生存率低于其阴性组,CD3、CD4、CD8、CD4/CD8阳性组5年生存率均低于其相应阴性组,差异均有统计学意义(P<0.05);CEA及T淋巴细胞亚群双阳性组5年生存率低于其双阴性组,差异有统计学意义(P<0.05),但与CEA阳性组、T淋巴细胞亚群阳性组相比,差异均无统计学意义(P>0.05)。结论术前检测T淋巴细胞亚群与CEA可为直肠癌患者预后提供有效参考。
Objective To investigate the relationship between preoperative T-lymphocyte subsets,carcinoembryonic antigen(CEA)levels and prognosis of rectal cancer patients.Methods The clinicopathological data of 92 patients with rectal cancer undergoing radical surgery in the hospital from January 2012 to April 2013 were retrospectively collected.We conducted follow-up study on the postoperative patients via telephone,WeChat,E-mail,etc.The relationship between preoperative T-lymphocyte subsets,CEA levels and clinicopathologic feature,prognosis of the patients were analyzed.Results The results of univariate analysis showed that the serum CEA level was related to the depth of tumor invasion,lymph node metastasis,histological type,vessel invasion and TNM stages(P<0.05).The T-lymphocyte subsets was related to the depth of tumor invasion,neural invasion and TNM stages(P<0.05).The five-year survival rate of positive group for CEA was lower than that of the negative group,the five-year survival rate of the positive group for T-lymphocyte subsets was lower than that of the negative group,the five-year survival rate of positive group for CD3、CD4、CD4/CD8 and CD8were also lower than those of the negative group,the differences were statistically significant(P<0.05);and the five-year survival rate of the double positive group for the CEA and T-lymphocyte subsets was lower than that of the double negative group,the differences was statistically significant(P<0.05),but compared with the positive group for CEA,and the positive group for T-lymphocyte,the differences were not statistically significant(P>0.05).Conclusion Preoperative T-lymphocyte subsets and CEA can provide an effective reference for the prognosis of patients with rectal cancer.
Objective To investigate the relationship between preoperative T-lymphocyte subsets,carcinoembryonic antigen(CEA)levels and prognosis of rectal cancer patients.Methods The clinicopathological data of 92 patients with rectal cancer undergoing radical surgery in the hospital from January 2012 to April 2013 were retrospectively collected.We conducted follow-up study on the postoperative patients via telephone,WeChat,E-mail,etc.The relationship between preoperative T-lymphocyte subsets,CEA levels and clinicopathologic feature,prognosis of the patients were analyzed.Results The results of univariate analysis showed that the serum CEA level was related to the depth of tumor invasion,lymph node metastasis,histological type,vessel invasion and TNM stages(P<0.05).The T-lymphocyte subsets was related to the depth of tumor invasion,neural invasion and TNM stages(P<0.05).The five-year survival rate of positive group for CEA was lower than that of the negative group,the five-year survival rate of the positive group for T-lymphocyte subsets was lower than that of the negative group,the five-year survival rate of positive group for CD3、CD4、CD4/CD8 and CD8were also lower than those of the negative group,the differences were statistically significant(P<0.05);and the five-year survival rate of the double positive group for the CEA and T-lymphocyte subsets was lower than that of the double negative group,the differences was statistically significant(P<0.05),but compared with the positive group for CEA,and the positive group for T-lymphocyte,the differences were not statistically significant(P>0.05).Conclusion Preoperative T-lymphocyte subsets and CEA can provide an effective reference for the prognosis of patients with rectal cancer.
引文
[1]GIESSEN C,NAGEL D,GLAS M,et al.Evaluation of preoperative serum markers for individual patient prognosis in stageⅠ-Ⅲrectal cancer[J].Tumour Biol,2014,35(10):10237-10248.
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[4]严健,原永明,张舒,等.CD3+、CD4+、CD8+T淋巴细胞亚群在肿瘤患者外周血中检测的临床意义[J].检验医学,2013,28(10):901-903.
[5]钟武,张磊昌,钟世彪,等.结直肠癌患者术前CEA,CA19-9浓度与临床病理特征及预后的关系[J].中国普通外科杂志,2015,24(4):499-504.
[6]何英武.T淋巴细胞及亚群在不同疾病的表达及临床意义[J].基层医学论坛,2016,20(6):816-817.
[7]王嘉,曲秀娟,张敬东,等.肠癌患者外周血T淋巴细胞亚群数量及临床意义[J].中国医科大学学报,2014,43(4):289-292.
[8]孙智.四种恶性肿瘤患者外周血T淋巴细胞亚群变化及意义[J].中国药物经济学,2017,12(1):155-157.
[9]李波.结直肠癌患者外周血中淋巴细胞亚群的改变[J].全科医学临床与教育,2016,14(5):503-505.
[10]张小龙,高枫,唐卫中,等.结直肠癌患者细胞免疫功能的影响因素分析[J].结直肠肛门外科,2014,20(2):83-86.
[11]POSSELT R,ERLENBACH-WNSCH K,HAAS M,et al.Spatial distribution of FoxP3+and CD8+tumour infiltrating T cells reflects their functional activity[J].Oncotarget,2016,7(37):60383-60394.
[12]张勇超,李潜,谢建国,等.直肠癌及癌前病变患者外周血髓源抑制细胞的表达及其临床意义[J].癌症进展,2018,16(4):503-505.
[13]林双明,郑志学,步召德,等.术前血清肿瘤标志物水平在直肠癌术前分期中的应用评价[J].中国肿瘤,2014,23(7):616-620.
[14]宫媛,吴本俨,苏斌斌.272例直肠癌患者的预后影响因素分析[J].解放军医学杂志,2008,33(5):608-610.
[15]胡书生,王慜杰,高佳,等.术前血清CEA在结直肠癌患者预后判断上的作用[J].标记免疫分析与临床,2012,19(6):333-337.
[16]郑成军,赵雪云,王健,等.264例直肠癌预后的影响因素分析[J].重庆医学,2014,43(1):122-124.
[2]LI DG,RUBINO AS,LATINO R,et al.Preoperative carcinoembryonic antigen and prognosis of colorectal cancer[J].An independent prognostic factor still reliable[J].Int Surg,2015,100(4):617-625.
[3]胡小倩.肠道恶性肿瘤患者外周血T淋巴细胞亚群分析及临床意义[J].国际检验医学杂志,2015,36(5):688-689.
[4]严健,原永明,张舒,等.CD3+、CD4+、CD8+T淋巴细胞亚群在肿瘤患者外周血中检测的临床意义[J].检验医学,2013,28(10):901-903.
[5]钟武,张磊昌,钟世彪,等.结直肠癌患者术前CEA,CA19-9浓度与临床病理特征及预后的关系[J].中国普通外科杂志,2015,24(4):499-504.
[6]何英武.T淋巴细胞及亚群在不同疾病的表达及临床意义[J].基层医学论坛,2016,20(6):816-817.
[7]王嘉,曲秀娟,张敬东,等.肠癌患者外周血T淋巴细胞亚群数量及临床意义[J].中国医科大学学报,2014,43(4):289-292.
[8]孙智.四种恶性肿瘤患者外周血T淋巴细胞亚群变化及意义[J].中国药物经济学,2017,12(1):155-157.
[9]李波.结直肠癌患者外周血中淋巴细胞亚群的改变[J].全科医学临床与教育,2016,14(5):503-505.
[10]张小龙,高枫,唐卫中,等.结直肠癌患者细胞免疫功能的影响因素分析[J].结直肠肛门外科,2014,20(2):83-86.
[11]POSSELT R,ERLENBACH-WNSCH K,HAAS M,et al.Spatial distribution of FoxP3+and CD8+tumour infiltrating T cells reflects their functional activity[J].Oncotarget,2016,7(37):60383-60394.
[12]张勇超,李潜,谢建国,等.直肠癌及癌前病变患者外周血髓源抑制细胞的表达及其临床意义[J].癌症进展,2018,16(4):503-505.
[13]林双明,郑志学,步召德,等.术前血清肿瘤标志物水平在直肠癌术前分期中的应用评价[J].中国肿瘤,2014,23(7):616-620.
[14]宫媛,吴本俨,苏斌斌.272例直肠癌患者的预后影响因素分析[J].解放军医学杂志,2008,33(5):608-610.
[15]胡书生,王慜杰,高佳,等.术前血清CEA在结直肠癌患者预后判断上的作用[J].标记免疫分析与临床,2012,19(6):333-337.
[16]郑成军,赵雪云,王健,等.264例直肠癌预后的影响因素分析[J].重庆医学,2014,43(1):122-124.
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