术前CDCD8^+CDCD28^-T细胞含量在预测肾癌患者术后复发中的作用

The efficiency of pre-operative CD8^+CD28^-T cells to predict recurrence for patients with renal cell carcinoma

目的探索术前CD8^+CD28^-调节性T细胞(Treg)含量在预测肾细胞癌(RCC)患者术后复发的效能。方法术前检测33例接受肾癌根治术的RCC患者外周血CD8^+CD28^-Treg含量,术后进行为期60个月的随访,观察CD8+CD28-Treg与复发的关系,并与术前中性粒/淋巴细胞比值(NLR)进行对照。结果共有9例患者出现复发,占27.27%,平均复发时间均数为术后24个月;复发患者的CD8^+CD28^-Treg及NLR数值均大于非复发组(P=0.034、0.041)。受试者工作曲线分析显示CD8+CD28-Treg及NLR均与RCC存在显著相关性,曲线下面积分别为0.819及0.703(P=0.004及0.021),且当CD8^+CD28^-Treg为8.21%时,其预测复发的敏感度为92.6%,特异度为90.5%,显著高于NLR。结论术前CD8^+CD28^-Treg在预测RCC患者术后复发具有较理想的准确度,对于术前该细胞百分含量高于8.21%的患者需在术后2年内加强随访。

Objective To explore the efficiency of pre-operative CD8~＋CD28^-T cells to predict recurrence for patients with renal cell carcinoma（RCC）. Methods Preoperative detection of 33 cases with kidney cancer in RCC patients with peripheral blood CD8~＋CD28^-Treg content, for 60 months of follow-up, postoperative observation of CD8~＋CD28^-Treg and recurrence relations, and compared with preoperative neutral grain/lymphocyte ratio（NLR） were compared. Results A total of 9 cases of patients with recurrence, accounted for 27.27%, the average recurrence time mean for 24 months after surgery; Patients with recurrence of CD8~＋CD28^-Treg and NLR numerical group were greater than the recurrence（P=0.034, 0.041）.Subjects work curve（ROC）analysis showed that CD8＋CD28-there was a significant correlation with RCC Treg and NLR, the area under the curve（AUC）were 0.819 and 0.703（P=0.004 and 0.004）, and when CD8~＋CD28^-Treg was 8.21%, the sensitivity of the recurrence of its predictions for 92.6%, 90.5%, significantly higher than that of NLR. Conclusion Preoperative CD8＋CD28-Treg in predicting recurrence of patients with RCC has ideal accuracy, for the cell percentage is higher than 8.21% of patients with preoperative need strengthen follow-up of 2 years after surgery.