结直肠癌患者围手术期T淋巴细胞亚群检测的意义及临床应用研究

Significance and Clinical Application of T Lymphocyte Subsets in Perioperative Period in Patients with Colorectal Cancer

目的:探讨结直肠癌患者围手术期T淋巴细胞亚群的变化及其与肿瘤进展的关系。方法:选择2021年5月—2022年5月我院收治的40例结直肠癌患者入选观察组,另选择同时期于我院进行身体健康检查的60名健康人员入选对照组。分别检测外周血T淋巴亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))的表达比例,并分析观察组患者不同临床特征下CD4^(+)/CD8^(+)变化情况。结果:观察组术前与术后10天CD3^(+)、CD4^(+)均低于对照组,CD8^(+)高于对照组(P<0.05)。观察组术后10天CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于术前,CD8^(+)低于术前(P<0.05)。单因素分析结果表明,结直肠癌患者肿瘤直径、淋巴结转移、TNM分期均与其免疫功能低下有密切关联性(P<0.05)。多因素分析结果显示,结直肠癌患者免疫能力低下的主要危险因素为肿瘤直径>4cm、有淋巴结转移、TNM分期Ⅲ+Ⅳ期(P<0.05)。结论:结直肠癌患者存在不同程度免疫能力下降,对结直肠患者围手术期进行T淋巴细胞亚群检测可为疾病的诊断提供数据支持,还可为评估患者病情进展及治疗效果情况提供临床依据,具有较高的临床应用价值。

Objective:To investigate the changes of T lymphocyte subsets in patients with colorectal cancer during perioperative period and its relationship with tumor progression.Methods:A total of 40 patients with colorectal cancer admitted to our hospital from May 2021 to May 2022 were selected as the observation group,and 60 healthy people who underwent physical health examination in our hospital at the same time were selected as the control group.The expression ratio of peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))was detected,and the changes of CD4^(+)/CD8^(+)in observation group were analyzed under different clinical characteristics.Results:CD3^(+)and CD4^(+)in the observation group were lower than those in the control group before and 10 days after operation,and CD8^(+)was higher than that in the control group(P<0.05).In the observation group,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those before operation at 10 days after operation,and CD8^(+)was lower than that before operation(P<0.05).The results of univariate analysis showed that tumor diameter,lymph node metastasis and TNM stage were closely correlated with immune dysfunction in colorectal cancer patients(P<0.05).The results of multivariate analysis showed that the main risk factors of immunocompromised capacity in colorectal cancer patients were tumor diameter>4cm,lymph node metastasis,and TNM stageⅢ+Ⅳ(P<0.05).Conclusions:Colorectal cancer patients have different degrees of immune decline.The detection of T lymphocyte subsets in colorectal patients during the perioperative period can provide data support for the diagnosis of the disease,and provide clinical basis for the evaluation of disease progression and treatment effect,which has high clinical application value.