| 摘要: |
| 目的探讨人循环T细胞免疫指数（CTII）模型评估结直肠癌患者手术预后的价值。方法根据行手术切除且经病理证实为结直肠癌的138例患者的循环血T细胞信息绘制ROC曲线，评价CTII模型对结直肠癌术后的预测能力，并确定最佳截点值进行分组。根据Kaplan-Meier曲线分析无病生存时间（RFS）和总生存时间（OS）。采用Cox比例风险回归模型分析影响预后的因素。结果对138例结直肠癌患者随访5年，失访10例。根据ROC曲线，确定以RFS为研究基础，获得CTII最佳截点值为0.08。按该值分为低CTII组（＜0.08）62例和高CTII组（≥0.08）76例。不同CTII组患者的TNM分期、分化程度以及循环CD4+调节性T细胞、CD8+调节性T细胞、CD28+细胞毒性T细胞比较，差异均有统计学意义（均P＜0.05）。高CTII组患者RFS、OS均明显低于低CTII组（均P＜0.01）。Cox比例风险回归模型分析结果显示，TNM分期（HR=2.274，95%CI：1.455~3.555；HR=0.197，95%CI：0.155~2.463）、分化程度（HR=2.982，95%CI：1.082~5.429；HR=1.867，95%CI：0.930~3.774）、CTII（HR=1.738，95%CI：1.012~2.894；HR=1.987，95%CI：1.188~3.182）是影响结直肠癌患者术后RFS和OS的独立危险因素（均P＜0.05）。结论CTII模型对结直肠癌患者手术预后的评估具有指导价值，是一项易检测、重复性好、价格低廉的肿瘤相关性炎症指标；其中高CTII提示预后不良。 |
| 关键词: 循环 T 细胞免疫指数 结直肠癌 预后 |
| DOI：10.12056/j.issn.1006-2785.2018.40.13.2018-395 |
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| Circulating T-cell immune index in prognosis assessment of colorectal cancer |
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Hangzhou Third People's Hospital
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| Abstract: |
| Objective To evaluate the application of circulating T-cell immune index (CTII) in prognosis assessment of colorectal cancer. Methods One hundred and thirty-eight patients with colorectal cancer undergoing radical resection were enrolled in the study and completed 5-year follow-up. The circulating T-cell immune index was calculated:
CTII=CD28+T-cell/CD4+ T-cell ×CD8+T-cell. The recurrence-free survival (RFS) and overall survival (OS) were analyzed by
Kaplan-Meier method. The value of CTII for predictive post-operative outcomes was analyzed with receiver operating characteristic (ROC) curve. Univariate and multivariate Cox regression models were applied to evaluate the association of various preoperative parameters with prognosis of patients. Results Based on ROC analysis CTII 0.08 was determined as the optimal cut off value for predicting RFS, and the patients were divided into low CTII (n=62) and high CTII groups (n=76). There were significant differences in TNM stage, tumor differentiation, circulating CD4+ regulatory T cells, CD8+ regulatory T cells, and CD28+
cytotoxic T cells between two groups (all P＜0.05). RFS and OS of patients in high CTII group were shorter than those in low CTII
group (P＜ 0. 01). Univariate and multivariate Cox analysis showed that tumor stage(HR=2.274, 95% CI : 1. 455-3.555, HR= 0.197, 95%CI: 0.155-2.463), tumor differentiation (HR=2.982, 95%CI: 1.082-5.429, HR=1.867, 95%CI: 0.930-3.774), CTII (HR=
1.738, 95%CI:1.012-2.894, HR=1.987, 95% CI:1.188-3.182) were independent risk factors for poorer prognosis of patients with colorectal cancer(all P＜0.05). Conclusion The CTII model is of value for prognosis of colorectal cancer patients, and higher CTII indicates a poorer prognosis. |
| Key words: Circulating T cell immune index Colorectal cancer Prognosis |
