辅助性T细胞9及其细胞因子表达水平与宫颈癌患者进展风险的相关性

Correlation between Th9 cell and its cytokine expression and risk of progression in patients with cervical cancer

目的探讨辅助性T细胞9(Th9)及其细胞因子白介素-9(IL-9)表达水平与宫颈癌患者进展风险的相关性及其在早期评估宫颈癌患者疾病进展中的价值。方法纳入2016年3月至2018年6月新疆维吾尔自治区人民医院收治的100例宫颈癌患者作为研究对象,收集患者临床资料及病理结果,检测所有患者血清IL-9、外周血Th9水平,采用免疫组化法检测宫颈癌组织中IL-9阳性细胞比例;随访3年,根据患者是否出现疾病进展分为进展组和非进展组,对比两组患者临床及实验室资料;采用多因素Logistic回归模型分析影响宫颈癌患者疾病进展的相关因素,绘制受试者工作特征(ROC)曲线分析Th9及IL-9水平在早期评估宫颈癌患者疾病进展中的应用价值。结果截止2021年5月31日,除8例失访患者外,92例患者中共有37例出现疾病进展。进展组分化程度、国际妇产科联盟(FIGO)分期与非进展组比较,差异具有统计学意义(P<0.05);进展组外周血Th9比例、IL-9水平及癌组织IL-9阳性细胞计数明显高于非进展组(P<0.05)。Logistic回归模型显示,FIGO分期(OR=2.464)、低分化(OR=4.069)、外周血Th9比例(OR=622.523)及癌组织中IL-9阳性细胞数量(OR=1.657)是宫颈癌患者出现进展的独立危险因素(P<0.05);ROC曲线分析显示,外周血Th9比例及癌组织中IL-9阳性细胞计数在早期评估宫颈癌患者3年疾病进展风险的曲线下面积(AUC)分别为0.873、0.820,其诊断灵敏度分别为72.97%、83.78%,特异度分别为90.91%、70.91%。结论Th9及其分泌的IL-9细胞因子与宫颈癌患者进展风险密切相关,并具有较高的预测价值。

Objective To investigate the correlation between the expression levels of helper T cell 9(Th9)and its cytokine interleukin-9(IL-9)and the risk of progression in cervical cancer patients and its value in the early assessment of disease progression in cervical cancer patients.Methods From March 2016 to June 2018,100 cervical cancer patients admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region were included as study subjects,clinical data and pathological findings of patients were collected,serum IL-9 and peripheral blood Th9 levels of all patients were detected,and the proportion of IL-9 positive cells in cervical cancer tissues was detected by immunohistochemistry;patients were followed up for 3 years,and were divided into progressive and non-progressive group according to whether they showed disease progression,and the clinical and laboratory data of the two groups were compared;multi-factor logistic regression equation model was used to analyze the relevant factors affecting the disease progression of cervical cancer patients,and receiver operating characteristic(ROC)curves were drawn to analyze the application value of Th9 and IL-9 levels in the early assessment of disease progression of cervical cancer patients.Results As of May 31,2021,a total of 37 of 92 patients showed disease progression,except for 8 patients who were lost to follow-up.The degree of differentiation and the international federation of gynecology and obstetrics(FIGO)stage were statistically significant in the progressive group compared with the non-progressive group(P<0.05);the peripheral blood Th9 ratio,IL-9 level and IL-9 positive cell count in cancer tissue were significantly higher in the progressive group than in the non-progressive group(P<0.05).Logistic regression equations showed that the FIGO stage(OR=2.464),the hypofractionation(OR=4.069),peripheral blood Th9 ratio(OR=622.523)and IL-9 positive cell count in cancer tissue(OR=1.657)were independent risk factors for progression in patients with cervical cancer(P<0.05);ROC curve analysis showed that the proportion of Th9 in peripheral blood and the count of IL-9 positive cells in cancer tissue were 0.873 and 0.820 respectively in the early assessment of 3-year risk of disease progression in cervical cancer patients.The diagnostic sensitivity were 72.97%and 83.78%,respectively,and specificity were 90.91%and 70.91%,respectively.Conclusions Th9 and its secreted IL-9 cytokines are closely related to the risk of cervical cancer progression and have high predictive value.