免疫功能水平与腹腔镜结直肠癌根治术后复发的相关性研究

Correlation between Changes of Immune Function and Recurrence after Laparoscopic Radical Resection of Colorectal Cancer

目的:研究免疫功能水平与腹腔镜结直肠癌根治术后复发率的相关性。方法:回顾性选取2016年1月—2017年1月年于河北中石油中心医院治疗的120例结直肠癌患者作为研究对象,对患者进行为期3年的随访,根据是否复发分为复发组和对照组,每组60例。观察两组患者的临床资料及免疫指标水平,对比分析两组患者的相关指标是否存在差异。结果:两组患者的肿瘤分化程度、TNM分期、切缘阳性率、淋巴结转移情况及脉管浸润情况差异均有统计学意义(P<0.05)。复发组患者血清中CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平(24.62±4.06、22.31±3.89、1.03±0.28)及免疫球蛋白水平[(4.17±0.63)g/L、(0.51±0.09)g/L、(0.83±0.28)g/L]均低于对照组,分别为(43.26±4.73、34.39±4.12、1.47±0.36)、[(5.70±0.92)g/L、(0.68±0.13)g/L、(0.94±0.31)g/L],差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,TNM分期高、免疫指标低、淋巴结转移阳性及脉管浸润是结肠癌患者术后复发的独立危险因素(P<0.05)。结论:腹腔镜结直肠癌根治术后复发与患者体内免疫功能水平的变化有密切关系,应定期检测观察,降低复发率。

Objective To investigate the correlation between immune function and recurrence rate after laparoscopic radical resection of colorectal cancer.Methods 120 patients with colorectal cancer treated in Hebei CNPC Central Hospital from January 2016 to January 2017 were retrospectively selected as the research object.The patients were followed up for three years.They were divided into recurrence group and control group according to whether they relapsed.The levels of clinical data and immune indexes of the two groups were observed,and the relevant indexes of the two groups were compared and analyzed.Results The univariate analysis of all factors showed that there were differences in tumor differentiation,TNM stage,positive rate of cutting edge,lymph node metastasis and vascular infiltration(P<0.05).At the same time,the serum levels of CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and immunoglobulin(4.17±0.63 g/L,0.51±0.09 g/L,0.83±0.28 g/L)in the recurrence group were significantly lower than those in the control group(43.26±4.73,34.39±4.12,1.47±0.36)(5.70±0.92 g/L,0.68±0.13 g/L,0.94±0.31 g/L)(P<0.05).It shows that the changes of immune function are closely related to the recurrence after laparoscopic radical resection of colorectal cancer.Multivariate logistic regression analysis showed that the higher the TNM stage,the lower the immune index,the positive lymph node metastasis and vascular infiltration were the important influencing factors of postoperative recurrence in patients with colon cancer(P<0.05).Conclusion The recurrence after laparoscopic radical resection of colorectal cancer is closely related to the changes of immune function in patients.It is worthy of regular clinical detection and observation to reduce the recurrence rate.