Yuan Chaofeng, Huang Jiannan, Li Haitao, Zhai Rongnan, Zhai Jinjing, Fang Xuedong, Wu Yuanyu
Department of Gastrointestinal Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China.
Front Surg. 2023 May 3;10:1102545. doi: 10.3389/fsurg.2023.1102545. eCollection 2023.
Tumor immunity is a hot topic in tumor research today, and human immunity is closely related to tumor progression. T lymphocyte is an important component of human immune system, and the changes in their subsets may influence the progression of colorectal cancer (CRC) to some extent. This clinical study systematically describes and analyzes the association of CD4 and CD8 T-lymphocyte content and CD4/CD8 T-lymphocyte ratio with CRC differentiation, clinical pathological stage, Ki67 expression, T-stage, N-stage, carcinoembryonic antigen (CEA) content, nerve and vascular infiltration, and other clinical features, as well as preoperative and postoperative trends. Furthermore, a predictive model is constructed to evaluate the predictive value of T-lymphocyte subsets for CRC clinical features.
Strict inclusion and exclusion criterion were formulated to screen patients, preoperative and postoperative flow cytometry and postoperative pathology reports from standard laparoscopic surgery were assessed. PASS and SPSS software, R packages were invoked to calculate and analyze.
We found that a high CD4 T-lymphocyte content in peripheral blood and a high CD4/CD8 ratio were associated with better tumor differentiation, an earlier clinical pathological stage, lower Ki67 expression, shallower tumor infiltration, a smaller number of lymph node metastases, a lower CEA content, and a lower likelihood of nerve or vascular infiltration ( < 0.05). However, a high CD8 T-lymphocyte content indicated an unpromising clinical profile. After effective surgical treatment, the CD4 T-lymphocyte content and CD4/CD8 ratio increased significantly ( < 0.05), while the CD8 T-lymphocyte content decreased significantly ( < 0.05). Further, we comprehensively compared the merits of CD4 T-lymphocyte content, CD8 T-lymphocyte content, and CD4/CD8 ratio in predicting the clinical features of CRC. We then combined the CD4 and CD8 T-lymphocyte content to build models and predict major clinical characteristics. We compared these models with the CD4/CD8 ratio to explore their advantages and disadvantages in predicting the clinical features of CRC.
Our results provide a theoretical basis for the future screening of effective markers in reflecting and predicting the progression of CRC. Changes in T lymphocyte subsets affect the progression of CRC to a certain extent, while their changes also reflect variations in the human immune system.
肿瘤免疫是当今肿瘤研究中的一个热门话题，人体免疫与肿瘤进展密切相关。T淋巴细胞是人体免疫系统的重要组成部分，其亚群的变化可能在一定程度上影响结直肠癌（CRC）的进展。本临床研究系统地描述并分析了CD4和CD8 T淋巴细胞含量以及CD4/CD8 T淋巴细胞比值与CRC分化、临床病理分期、Ki67表达、T分期、N分期、癌胚抗原（CEA）含量、神经和血管浸润以及其他临床特征的相关性，以及术前和术后的变化趋势。此外，构建了一个预测模型来评估T淋巴细胞亚群对CRC临床特征的预测价值。
制定严格的纳入和排除标准以筛选患者，评估术前和术后的流式细胞术以及标准腹腔镜手术的术后病理报告。调用PASS和SPSS软件、R包进行计算和分析。
我们发现外周血中高CD4 T淋巴细胞含量和高CD4/CD8比值与更好的肿瘤分化、更早的临床病理分期、更低的Ki67表达、更浅的肿瘤浸润、更少的淋巴结转移数量、更低的CEA含量以及更低的神经或血管浸润可能性相关（<0.05）。然而，高CD8 T淋巴细胞含量表明临床预后不佳。经过有效的手术治疗后，CD4 T淋巴细胞含量和CD4/CD8比值显著增加（<0.05），而CD8 T淋巴细胞含量显著降低（<0.05）。此外，我们全面比较了CD4 T淋巴细胞含量、CD8 T淋巴细胞含量和CD4/CD8比值在预测CRC临床特征方面的优缺点。然后我们结合CD4和CD8 T淋巴细胞含量构建模型并预测主要临床特征。我们将这些模型与CD4/CD8比值进行比较，以探讨它们在预测CRC临床特征方面的优缺点。
我们的结果为未来筛选反映和预测CRC进展的有效标志物提供了理论依据。T淋巴细胞亚群的变化在一定程度上影响CRC的进展，同时它们的变化也反映了人体免疫系统的变化。
