Luo Kai, Tang Haijun, Yan Weijie, Li Shanhang, Luo Xiaoting, Yang Mingxiu, Li Feicui, Liang Jiming, Liao Shijie, Liu Yun, He Juliang, Liu Dehuai H
Department of Spine and Osteopathy, the First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China.
Department of Bone and soft Tissue Oncology, Affiliated Cancer Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China.
World J Surg Oncol. 2025 Apr 9;23(1):130. doi: 10.1186/s12957-025-03784-4.
There is no study on the relationship between peripheral blood different lymphocyte subtypes and the prognosis of osteosarcoma (OS). Therefore, this study aims to investigate the predictive value of T cells and natural killer (NK) cells for the prognosis of OS patients.
This study retrospectively analyzed the clinical data and preliminary laboratory indicators of patients with OS admitted from dual-center between January 2014 and January 2021. The receiver operating characteristic (ROC) curve was employed to determine optimal cutoff values for different lymphocyte subtypes, with T cells, NK cells, and B lymphocytes subsequently stratified into high- and low-proportion groups based on their respective optimal cutoff values. Kaplan-Meier curve was employed to analyze the impact of different lymphocyte on survival time and status. Univariate and multivariate Cox analyses were performed on clinical and laboratory indicators to identify independent prognostic factors influencing the prognosis of OS patients.
After screening 277 patients with OS, a total of 106 patients were eligible for this study. The median follow-up time was 36.00 months. At the last follow-up, patients were categorized as having a good prognosis if they survived or a poor prognosis if they died: good prognosis (n = 48) and poor prognosis (n = 58). Kaplan-Meier curve revealed that patients with a high proportion of T (Median overall survival: 41 months vs. 32 months, P = 0.007) and NK (Median overall survival: 44 months vs. 32 months, P = 0.004) cells had a better prognosis compared to those with a low proportion. Univariate analysis indicated that age, body mass index (BMI), C-reactive protein (CRP), tumor size, Enneking stage, surgical method, and the proportions of T, NK, and B cells were associated with the prognosis of OS patients (P < 0.05). Multivariate analysis indicated that Enneking stage (II vs. I, HR = 12.543, P = 0.015; III vs. I, HR = 29.078, P = 0.001), and the proportions of T and NK cells (HR = 0.466, P = 0.048; HR = 0.497, P = 0.029) were independent factors influencing the prognosis of OS patients (P < 0.05).
The proportions of T and NK cells may serve as efficient and practical prognostic indicators for OS patients, with higher proportions often associated with a better prognosis.
目前尚无关于外周血不同淋巴细胞亚群与骨肉瘤（OS）预后关系的研究。因此，本研究旨在探讨T细胞和自然杀伤（NK）细胞对OS患者预后的预测价值。
本研究回顾性分析了2014年1月至2021年1月期间双中心收治的OS患者的临床资料和初步实验室指标。采用受试者工作特征（ROC）曲线确定不同淋巴细胞亚群的最佳截断值，随后根据各自的最佳截断值将T细胞、NK细胞和B淋巴细胞分为高比例组和低比例组。采用Kaplan-Meier曲线分析不同淋巴细胞对生存时间和状态的影响。对临床和实验室指标进行单因素和多因素Cox分析，以确定影响OS患者预后的独立预后因素。
筛选出277例OS患者后，共有106例患者符合本研究条件。中位随访时间为36.00个月。在最后一次随访时，存活患者被归类为预后良好，死亡患者被归类为预后不良：预后良好（n = 48）和预后不良（n = 58）。Kaplan-Meier曲线显示，T细胞比例高（中位总生存期：41个月对32个月，P = 0.007）和NK细胞比例高（中位总生存期：44个月对32个月，P = 0.004）的患者预后优于比例低的患者。单因素分析表明，年龄、体重指数（BMI）、C反应蛋白（CRP）、肿瘤大小、Enneking分期、手术方法以及T、NK和B细胞比例与OS患者的预后相关（P < 0.05）。多因素分析表明，Enneking分期（II期对I期，HR = 12.543，P = 0.015；III期对I期，HR = 29.078，P = 0.001）以及T细胞和NK细胞比例（HR = 0.466，P = 0.048；HR = 0.497，P = 0.029）是影响OS患者预后的独立因素（P < 0.05）。
T细胞和NK细胞比例可能是OS患者有效且实用的预后指标，比例越高通常预后越好。
