No. 2 Disease Aarea of Radiotherapy Abdomen and Pelvis, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China.
No. 3 Department of Gastroenterology, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China.
Cancer Radiother. 2021 Feb;25(1):72-76. doi: 10.1016/j.canrad.2020.08.045. Epub 2021 Jan 5.
PURPOSE: This study aimed to compare the absolute numbers of various types of lymphocytes in the peripheral blood before and after chemotherapy following radio-chemotherapy in patients with cervical cancer, so as to explore the correlation between the changes in the absolute numbers of peripheral various types of lymphocytes and the overall survival rate of patients. METHODS: Data of 205 patients with cervical cancer admitted to the hospital from June 2014 to August 2016 were retrospectively analyzed. These patients underwent concurrent radio-chemotherapy, followed by chemotherapy. The absolute numbers of peripheral blood lymphocytes and subtypes were compared before and after re-chemotherapy. RESULTS: For patients with a good prognosis, the number of lymphocytes, T cells, and cytotoxic T cells (Tc) significantly decreased (P<0.05) after re-chemotherapy, while this phenomenon was not observed in patients with poor prognosis. Kaplan-Meier univariate analysis showed that patients with cervical cancer who had an advanced FIGO stage before treatment, presence of lymph node metastasis, and increased numbers of Tc and T helper cells after re-chemotherapy showed a low 30-month survival rate; the overall log-rank analysis showed significant differences (P<0.05). Multivariate Cox proportional hazards regression analysis, presence of lymph node metastasis: HR=9.718, P=0.002, 95% CI=0.183-0.679; Tc grouping: HR=3.239, P=0.0.072, 95% CI=0.950-03.347; Th group: HR=3.197, P=0.074, 95% CI=0.943-3.564. CONCLUSIONS: After radio-chemotherapy, in patients with advanced cervical cancer, the change in the numbers of peripheral blood Tc and Th before and after re-chemotherapy was associated with the 30-month overall survival rate of patients. It can be considered as a predictor of the survival of patients with advanced cervical cancer.
目的:本研究旨在比较宫颈癌放化疗后再化疗前后外周血各种类型淋巴细胞的绝对值,探讨外周血各种类型淋巴细胞绝对值的变化与患者总生存率的关系。
方法:回顾性分析 2014 年 6 月至 2016 年 8 月我院收治的 205 例宫颈癌患者的临床资料。这些患者接受了同期放化疗,然后进行化疗。比较再化疗前后外周血淋巴细胞及亚型的绝对值。
结果:对于预后良好的患者,再化疗后淋巴细胞、T 细胞和细胞毒性 T 细胞(Tc)数量明显减少(P<0.05),而预后不良的患者则没有这种现象。Kaplan-Meier 单因素分析显示,治疗前国际妇产科联盟(FIGO)分期较晚、存在淋巴结转移、再化疗后 Tc 和辅助性 T 细胞增多的宫颈癌患者 30 个月生存率较低;总对数秩分析差异有统计学意义(P<0.05)。多因素 Cox 比例风险回归分析显示,淋巴结转移:HR=9.718,P=0.002,95%CI=0.183-0.679;Tc 分组:HR=3.239,P=0.0.072,95%CI=0.950-03.347;Th 组:HR=3.197,P=0.074,95%CI=0.943-3.564。
结论:放化疗后,晚期宫颈癌患者再化疗前后外周血 Tc 和 Th 数量的变化与患者 30 个月总生存率有关,可作为晚期宫颈癌患者生存的预测指标。
Zhonghua Fu Chan Ke Za Zhi. 2019-6-25