Tang Yan-Ping, Xie Ming-Zhi, Li Ke-Zhi, Li Ji-Lin, Cai Zheng-Min, Hu Bang-Li
Department of Research, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning 530021, China, Nanning, 530021, Guangxi, People's Republic of China.
Department of Chemotherapy, Guangxi Medical University Cancer Hospital, Nanning, 530021, Guangxi, People's Republic of China.
BMC Gastroenterol. 2020 Feb 7;20(1):31. doi: 10.1186/s12876-020-1177-8.
The association between natural killer (NK) cells and survival in colorectal cancer (CRC) patients remains controversial. This study aimed to clarify the prognostic value of peripheral blood NK cells in CRC patients.
A total of 447 CRC patients who underwent radical surgery and chemotherapy were retrospectively analyzed. Cox regression analyses were used to identify independent prognostic indicators. Correlation between NK cell percentage and other clinicopathological features (gender, age, histological grade, tumor stage, immune cells, and inflammatory indicators) was analyzed. The prognostic values of the combinations of NK cell percentage and other clinicopathological features were also determined.
Multivariate Cox regression analysis revealed that NK cell percentage in the peripheral blood was an independent prognostic indicator in CRC patients. A higher percentage of NK cells indicated a longer survival time than a lower percentage. NK cell percentage was positively correlated to the T and B lymphocyte counts and negatively correlated to the patients' age and albumin levels. With an area of 0.741 under a receiver operating characteristic curve, NK cells have a moderate predictive value for 3rd-year survival in CRC. This area increased to 0.851 by combining NK cell percentage with the B lymphocyte count. Elderly patients and those at an advanced clinical stage presented a lower percentage of NK cells than younger patients and those at an early clinical stage.
This study demonstrated that NK cells in the blood were an independent predictor of survival in CRC patients, and the combined count of NK cells and B lymphocytes could increase the prognostic value.
自然杀伤（NK）细胞与结直肠癌（CRC）患者生存率之间的关联仍存在争议。本研究旨在阐明外周血NK细胞在CRC患者中的预后价值。
回顾性分析447例行根治性手术及化疗的CRC患者。采用Cox回归分析确定独立预后指标。分析NK细胞百分比与其他临床病理特征（性别、年龄、组织学分级、肿瘤分期、免疫细胞及炎症指标）之间的相关性。还确定了NK细胞百分比与其他临床病理特征组合的预后价值。
多因素Cox回归分析显示，外周血NK细胞百分比是CRC患者的独立预后指标。NK细胞百分比越高，生存时间越长。NK细胞百分比与T、B淋巴细胞计数呈正相关，与患者年龄及白蛋白水平呈负相关。NK细胞对CRC患者3年生存率的预测价值中等，受试者工作特征曲线下面积为0.741。将NK细胞百分比与B淋巴细胞计数相结合，该面积增至0.851。老年患者及临床晚期患者的NK细胞百分比低于年轻患者及临床早期患者。
本研究表明，血液中的NK细胞是CRC患者生存的独立预测指标，NK细胞与B淋巴细胞的联合计数可提高预后价值。
