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预测结肠癌术后患者肝转移的免疫功能状态

Immune function status of postoperative patients with colon cancer for predicting liver metastasis.

作者信息

Xiong Le, Liu Fang-Chen

机构信息

Department of Clinical Laboratory, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China.

Department of Blood Transfusion, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China.

出版信息

World J Gastrointest Surg. 2024 Feb 27;16(2):463-470. doi: 10.4240/wjgs.v16.i2.463.

Abstract

BACKGROUND

Colon cancer (CC) has a high incidence rate. Radical resection is the main treatment method for CC; however, liver metastasis (LM) often occurs post-surgery. The liver contains both innate and adaptive immune cells that monitor and remove abnormal cells and pathogens. Before LM, tumor cells secrete cytokines and exosomes to adjust the immune microenvironment of the liver, thus forming an inhibitory immune microenvironment for colonization by circulating tumor cells. This indicates that the immune state of patients with CC plays a crucial role in the occurrence and progression of LM.

AIM

To observe and analyze the relationship between immune status and expression of tumor factors in patients with LM of CC, and to provide a scientific intervention method for promoting the patient prognosis.

METHODS

A retrospective analysis was performed. The baseline data of 100 patients with CC and 100 patients with CC who suffered from postoperative LM and were admitted to our hospital from May 2021 to May 2023 were included in the non-occurrence and occurrence groups, respectively. The immune status of the patients and the expression of tumor factor-related indicators in the two groups were compared, and the predictive value of the indicators for postoperative LM in patients with CC was analyzed.

RESULTS

Compared with the non-occurrence group, the expression of serum carcinoembryonic antigen (CEA), CA19-9, CA242, CA72-4 and CA50 in patients in the occurrence group were significantly higher, while the expression of CD3+, CD4+, CD8+, natural killer (NK) and CD4+/CD25 in patients in the occurrence group were significantly lower ( < 0.05). No significant difference was observed in other baseline data between groups ( > 0.05). Multivariate logistic regression model analysis revealed that the expressions of CEA, CA19-9, CA242, CA72-4, CA50, CD3+, CD4+, CD8+, NK, and CD4+/CD25 were associated with the LM in patients with CC. High expressions of serum CEA, CA19-9, CA242, CA72-4 and CA50, and low expressions of CD3+, CD4+, CD8+, NK, and CD4+/CD25 in patients with CC were risk factors for LM (OR > 1, < 0.05). The receiver operating characteristic curve showed that the area under curve for CEA, CA19-9, CA242, CA72-4, CA50, CD3+, CD4+, CD8+, NK, and CD4+/CD25 in the prediction of LM in patients with CC were all > 0.80, with a high predictive value.

CONCLUSION

The expression of tumor factors and immune state-related indices in patients with CC is closely associated with the occurrence of LM.

摘要

背景

结肠癌(CC)发病率较高。根治性切除是CC的主要治疗方法;然而,术后常发生肝转移(LM)。肝脏含有先天性和适应性免疫细胞,可监测并清除异常细胞和病原体。在LM发生前,肿瘤细胞分泌细胞因子和外泌体来调节肝脏的免疫微环境,从而形成抑制循环肿瘤细胞定植的免疫微环境。这表明CC患者的免疫状态在LM的发生和发展中起关键作用。

目的

观察并分析CC伴LM患者免疫状态与肿瘤因子表达的关系,为改善患者预后提供科学的干预方法。

方法

进行回顾性分析。分别将2021年5月至2023年5月我院收治的100例CC未发生肝转移患者和100例CC术后发生肝转移患者的基线数据纳入未发生组和发生组。比较两组患者的免疫状态及肿瘤因子相关指标的表达情况,并分析各指标对CC患者术后LM的预测价值。

结果

与未发生组相比,发生组患者血清癌胚抗原(CEA)、CA19-9、CA242、CA72-4和CA50的表达显著升高,而发生组患者CD3+、CD4+、CD8+、自然杀伤细胞(NK)及CD4+/CD25的表达显著降低(P<0.05)。两组间其他基线数据比较差异无统计学意义(P>0.05)。多因素logistic回归模型分析显示,CEA、CA19-9、CA242、CA72-4、CA50、CD3+、CD4+、CD8+、NK及CD4+/CD25的表达与CC患者发生LM有关。CC患者血清CEA、CA19-9、CA242、CA72-4和CA50高表达及CD3+、CD4+、CD8+、NK及CD4+/CD25低表达是发生LM的危险因素(OR>1,P<0.05)。受试者工作特征曲线显示,CEA、CA19-9、CA242、CA72-4、CA50、CD3+、CD4+、CD8+、NK及CD4+/CD25预测CC患者发生LM的曲线下面积均>0.80,具有较高的预测价值。

结论

CC患者肿瘤因子表达及免疫状态相关指标与LM的发生密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c89/10921213/7b79da52a12f/WJGS-16-463-g001.jpg

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