| 摘要: |
| ［摘要］ 目的 分析外周血CD4+CD25+、CD8+CD28+调节性T细胞水平对早期宫颈癌（CC）患者腹腔镜根治术后预后的预测价值。方法 招募2018年9月至2020年9月于儋州市人民医院接受腹腔镜根治术治疗的早期CC患者204例，根据患者术后随访期间预后情况分为预后不良组（43例）和预后良好组（161例）。比较两组临床资料。采用Spearman秩相关分析外周血CD4+CD25+调节性T细胞水平与CD8+CD28+调节性T细胞水平的相关性。采用多因素logistic回归分析早期CC患者腹腔镜根治术后预后不良的影响因素。采用受试者工作特征（ROC）曲线评估外周血CD4+CD25+、CD8+CD28+调节性T细胞水平对早期CC患者腹腔镜根治术后预后不良的预测价值。结果 预后不良组CD4+CD25+调节性T细胞、癌胚抗原（CEA）、糖类抗原125（CA125）水平，术后切缘阳性占比以及术中宫旁浸润占比高于预后良好组，CD8+CD28+调节性T细胞水平低于预后良好组，差异有统计学意义（P<0.05）。Spearman秩相关分析结果显示，早期CC患者外周血CD4+CD25+调节性T细胞水平与CD8+CD28+调节性T细胞水平呈负相关（rs=-0.478，P<0.05）。多因素logistic回归分析结果显示，较高的CEA、CA125、CD4+CD25+调节性T细胞水平是促进早期CC患者腹腔镜根治术后预后不良发生的独立危险因素（P<0.05），较高的CD8+CD28+调节性T细胞水平是抑制早期CC患者腹腔镜根治术后预后不良发生的独立保护因素（P<0.05）。ROC曲线分析结果显示，外周血CD4+CD25+、CD8+CD28+调节性T细胞水平能有效预测早期CC患者腹腔镜根治术后预后不良（P<0.05），两项指标联合可进一步提高预测效能［AUC（95%CI）=0.939（0.898～0.979），P<0.001］，灵敏度和特异度分别为86.00%、88.20%。结论 外周血CD4+CD25+、CD8+CD28+调节性T细胞水平与早期CC患者腹腔镜根治术后预后不良有关，二者能有效预测早期CC患者腹腔镜根治术后预后不良。 |
| 关键词: 宫颈癌 腹腔镜根治术 CD4+CD25+调节性T细胞 CD8+CD28+调节性T细胞 预后 |
| DOI：10.3969/j.issn.1674-3806.2024.07.16 |
| 分类号:R 737.9 |
| 基金项目:海南省卫生计生行业科研项目（编号：18A200158） |
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| The predictive value of peripheral blood CD4+CD25+ and CD8+CD28+ regulatory T cell levels for the prognosis of early cervical cancer patients after laparoscopic radical resection |
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ZENG Hairong1, HUANG Dan1, ZHANG Jianjun2, HUA Haiqin3
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1.Department of Health Examination, Danzhou People′s Hospital, Hainan 571700, China; 2.Department of Laboratory Medicine, Danzhou People′s Hospital, Hainan 571700, China; 3.Department of Oncology, Danzhou People′s Hospital, Hainan 571700, China
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| Abstract: |
| ［Abstract］ Objective To analyze the predictive value of peripheral blood CD4+CD25+ and CD8+CD28+ regulatory T cell levels for the prognosis of early cervical cancer(CC) patients after laparoscopic radical resection. Methods A total of 204 patients with early CC who underwent laparoscopic radical resection in Danzhou People′s Hospital from September 2018 to September 2020 were enrolled. According to the prognosis of the patients during postoperative follow-up period, they were divided into poor prognosis group(43 cases) and good prognosis group(161 cases). The clinical data were compared between the two groups. Spearman rank correlation was used to analyze the correlation between peripheral blood CD4+CD25+ regulatory T cell levels and CD8+CD28+ regulatory T cell levels. Multivariate logistic regression was used to analyze the influencing factors of poor prognosis in patients with early CC after laparoscopic radical resection. Receiver operating characteristic(ROC) curve was used to evaluate the predictive value of peripheral blood CD4+CD25+ and CD8+CD28+ regulatory T cell levels for the poor prognosis of early CC patients after laparoscopic radical resection. Results The CD4+CD25+ regulatory T cells, carcinoembryonic antigen(CEA) and carbohydrate antigen 125(CA125) levels, the proportion of positive postoperative margin and the proportion of intraoperative parametrial infiltration in the poor prognosis group were higher than those in the good prognosis group. The CD8+CD28+ regulatory T cell levels in the poor prognosis group were lower than those in the good prognosis group, and the differences were statistically significant(P<0.05). The results of Spearman rank correlation analysis showed that there was a negative correlation between peripheral blood CD4+CD25+ regulatory T cell levels and CD8+CD28+ regulatory T cell levels in early CC patients(rs=-0.478, P<0.05). The results of multivariate logistic regression analysis showed that higher CEA, CA125 and CD4+CD25+ regulatory T cell levels were independent risk factors for promoting the occurrence of poor prognosis in the early CC patients after laparoscopic radical resection(P<0.05), and higher CD8+CD28+ regulatory T cell levels were independent protective factors for inhibiting the occurrence of poor prognosis in early CC patients after laparoscopic radical resection(P<0.05). The results of ROC curve analysis showed that peripheral blood CD4+CD25+ and CD8+CD28+ regulatory T cell levels could effectively predict poor prognosis of early CC patients after laparoscopic radical resection(P<0.05). The combination of the two indicators could further improve the predictive efficacy［AUC(95%CI)=0.939(0.898-0.979), P<0.001］, with sensitivity and specificity being 86.00% and 88.20%, respectively. Conclusion Peripheral blood CD4+CD25+ and CD8+CD28+ regulatory T cell levels are related to the poor prognosis of early CC patients after laparoscopic radical resection, and both indicators can effectively predict the poor prognosis of early CC patients after laparoscopic radical resection. |
| Key words: Cervical cancer(CC) Laparoscopic radical resection CD4+CD25+ regulatory T cell CD8+CD28+ regulatory T cell Prognosis |
