Treg和Th17在卵巢癌患者外周血中的意义及与预后的相关性分析

Significance of Treg and Th17 in peripheral blood of patients with ovarian cancer and their correlation with prognosis

目的:探讨调节性T细胞(Treg)和辅助性T细胞17(Th17)在卵巢癌患者外周血中表达的意义及其与预后的相关性。方法:选取2015年10月~2016年9月郑州大学第二附属医院收治的105例卵巢癌患者为卵巢癌组,随访统计患者3年期间的生存情况,将其分为生存组72例和死亡组33例;另取同期体检中心45例健康体检者设为健康组。流式细胞术检测卵巢癌组及健康组患者外周血Th17、Treg、Th17/Treg细胞百分率,并分析不同临床分期卵巢癌患者外周血Th17、Treg、Th17/Treg细胞百分率差异;比较存活组及死亡组患者外周血Th17、Treg、Th17/Treg细胞百分率及其他可能导致预后死亡的影响因素,并采用Logistic回归分析法明确相关危险因素。结果:卵巢癌组Th17、Treg和Th17/Treg细胞百分率均高于健康组[(2.94±0.61)%vs(1.05±0.24)%,(13.65±1.44)%vs(5.80±1.01)%、(21.54±2.47)%vs(18.10±2.01)%](P<0.001)。卵巢癌组Ⅲ~Ⅳ期患者Th17及Treg细胞百分率均高于Ⅰ~Ⅱ期患者[(3.25±0.70)%vs(2.51±0.41)%、(16.08±2.11)%vs(10.28±1.35)%](P<0.001);卵巢癌组Ⅲ~Ⅳ期患者Th17/Treg细胞百分率[(21.57±2.32)%]与Ⅰ~Ⅱ期患者[(21.51±2.67)%]相比差异无统计学意义(P>0.05)。死亡组临床分期Ⅲ~Ⅳ期、残存病灶>1 cm、化疗≤6个疗程患者构成比及Th17、Treg、Th17/Treg细胞百分率均高于存活组(P<0.05);经Logistic回归分析,临床分期、残存病灶大小、化疗疗程、Th17、Treg、Th17/Treg细胞百分率均是导致卵巢癌患者预后死亡的危险因素(OR=2.670、2.776、2.246、4.145、2.659、3.971,P<0.05)。结论:外周血Th17、Treg、Th17/Treg细胞百分率变化可能参与卵巢癌发生发展,且与疾病预后密切相关。

Objective:To investigate the significance of regulatory T cells(Treg)and helper T cells 17(Th17)expressions in peripheral blood of patients with ovarian cancer and their correlation with prognosis.Methods:105 ovarian cancer patients admitted to the Second Affiliated Hospital of Zhengzhou University from October 2015 to September 2016 were selected as ovarian cancer group.Survival conditions of patients during the three-year follow-up were analyzed and divided into survival group and death group.In addition,45 healthy examiners from physical examination center in same period were taken as healthy group.Percentage of Th17,Treg and Th17/Treg in peripheral blood of patients in ovarian cancer group and healthy group were detected by flow cytometry,and the difference of Th17,Treg and Th17/Treg cells in peripheral blood of patients with ovarian cancer at different clinical stages was analyzed.Difference of Th17,Treg,Th17/Treg cell percentage and other factors those may lead to the prognosis of patients in survival group and death group were compared,and the related risk factors were identified by Logistic regression analysis.Results:Percentage of Th17,Treg and Th17/Treg in ovarian cancer group were higher than that in healthy control group[(2.94±0.61)%vs(1.05±0.24)%,(13.65±1.44)%vs(5.80±1.01)%,(21.54±2.47)%vs(18.10±2.01)%](P<0.001).Percentage of Th17 and Treg in patients with stageⅢ-Ⅳovarian cancer were higher than those stageⅠ-Ⅱpatients[(3.25±0.70)%vs(2.51±0.41)%,(16.08±2.11)%vs(10.28±1.35)%](P<0.001).There was no significant difference in Th17/Treg cell percentage[(21.57±2.32)%]between patients with stageⅢ-Ⅳand patients with stageⅠ-Ⅱ[(21.51±2.67)%]in ovarian cancer group(P>0.05).Death group had clinical stagesⅢ-Ⅳ,residual lesions>1 cm,proportion of patients with chemotherapy≤6 courses of treatment,and percentages of Th17,Treg,and Th17/Treg cells were higher than those in survival group(P<0.05).According to Logistic regression analysis,clinical stage,residual focus size,chemotherapy course and Th17,Treg,Th17/Treg cell percentage were all the risk factors for prognosis and death of ovarian cancer(OR=2.670,2.776,2.246,4.145,2.659,3.971,P<0.05).Conclusion:Peripheral blood Th17,Treg,and Th17/Treg cell percentage changes may be involved in the development of ovarian cancer,and are closely related to disease prognosis.