结直肠癌患者血清总蛋白、白蛋白、血红蛋白与Th1/Th2免疫平衡及调节性T细胞、辅助性T细胞17相关性分析

Correlation analysis of serum total protein,albumin and hemoglobin with T cell immune balance,regulatory cell and T helper cell 17 in patients with colorectal cancer

目的探究结直肠癌患者血清总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)与其辅助性T细胞(Th)1/Th2免疫平衡及Treg、Th17相关性。方法使用主观全面评定量表中营养状态评分对2018年12月至2021年10月河北北方学院附属第一医院收治的结直肠癌患者500例进行营养评估,根据患者营养评估结果随机抽取其中营养状态优者162例,营养状态良者161例,营养状态差者177例。使用简单随机抽样法,选取营养状态优组(40例)、轻中度营养不良组(40例)、重度营养不良组(40例)。观察不同组别患者营养指标,Th1/Th2、Treg/Th17免疫平衡相关指标并进行相关性分析。结果营养状态优组TP、ALB、Hb、白细胞介素(IL)-2、γ-干扰素、肿瘤坏死因子-α、Th1细胞表达、Th1/Th2显著高于轻中度营养不良组及重度营养不良组(P<0.05),轻中度营养不良组显著高于重度营养不良组(P<0.05);营养状态优组运铁蛋白(TF)、IL-6、IL-10、IL-5、Th2细胞表达低于轻中度营养不良组及重度营养不良组(P<0.05),轻中度营养不良组显著低于重度营养不良组(P<0.05)。Pearson相关性分析显示,TP与患者IL-2、TNF-α水平及Th1细胞表达、Th1/Th2呈正相关(r=0.500、0.471、0.413、0.332,P<0.05),与IL-6、IL-10、IL-5水平及Th2、Treg、Th17细胞表达呈负相关(r=-0.443、-0.442、-0.396、-0.213、-0.422、-0.419,P<0.05);ALB与患者IL-2、IFN-γ、TNF-α水平及Th1细胞表达、Th1/Th2呈正相关(r=0.493、0.338、0.393、0.336、0.321,P<0.05),与IL-6、IL-10、IL-5水平及Th2、Treg、Th17细胞表达呈负相关(r=-0.360、-0.313、-0.269、-0.231、-0.369、-0.306,P<0.05);TF与患者IL-6、IL-10、IL-5水平及TH2、Treg、Th17细胞表达呈正相关(r=0.577、0.490、0.345、0.394、0.507、0.490,P<0.05),与IL-2、IFN-γ、TNF-α水平及Th1细胞表达、Th1/Th2呈负相关(r=-0.665、-0.401、-0.590、-0.540、-0.432,P<0.05);Hb与患者IL-2、TNF-α水平及Th1细胞表达呈正相关(r=0.280、0.392、0.194,P<0.05),与IL-6、IL-10、IL-5水平及Th2、Treg、Th17细胞表达呈负相关(r=-0.284、-0.188、-0.308、-0.210、-0.266、-0.327,P<0.05)。结论结直肠癌患者营养学指标与其Th1/Th2免疫平衡及Treg、Th17相关性具有相关性,随着结直肠癌患者营养学指标变化会引起其Th1/Th2免疫平衡及Treg、Th17表达水平改变,营养状态较差患者Th1/Th2免疫平衡向Th2漂移,Treg、Th17升高,抗肿瘤免疫能力减弱。

Objective To explore the correlation between serum total protein(TP),albumin(ALB)and hemoglobin(Hb)with T cell immune balance,regulatory cell and T helper cell 17.Methods Nutritional assessment was performed on 500 patients with colorectal cancer admitted to the First Affiliated Hospital of Hebei North University from December 2018 to October 2021 using nutritional status scores in the subjective comprehensive assessment nutrition screening table.According to the nutritional assessment results,162 patients with good nutritional status,161 patients with good nutritional status and 177 patients with poor nutritional status were randomly selected.Excellent nutritional status group(40 cases),mild to moderate malnutrition group(40 cases),severe malnutrition group(40 cases)were randomly selected.Nutritional indexes,Th1/Th2,Treg/Th17 immune balance related indexes of patients in different groups were observed and correlation analysis was conducted.Results The expression of TP,ALB,Hb,interleukin(IL)-2,interferon-γ,tumor necrosis factor-α,Th1 cells and Th1/Th2 cells in optimal nutrition group were significantly higher than those in mild-moderate malnutrition group and severe malnutrition group(P<0.05),and mild-moderate malnutrition group was significantly higher than that in severe malnutrition group(P<0.05).The expressions of transferrin(TF),L-6,IL-10,IL-5 and Th2 cells in optimal nutrition group were lower than those in mild-moderate malnutrition group and severe malnutrition group(P<0.05),and mild-moderate malnutrition group was significantly lower than those in severe malnutrition group(P<0.05).Pearson correlation analysis showed that TP was positively correlated with IL-2,TNF-αlevels,Th1 cell expression and Th1/Th2(r=0.500,0.471,0.413,0.332,P<0.05),it was negatively correlated with the levels of IL-6,IL-10 and IL-5 and the expression of Th2,Treg and Th17 cells(r=-0.443,-0.442,-0.396,-0.213,-0.422,-0.419,P<0.05);ALB was positively correlated with the levels of IL-2,IFN-γ,TNF-α,Th1 cell expression and Th1/Th2(r=0.493,0.338,0.393,0.336,0.321,P<0.05),it was negatively correlated with the levels of IL-6,IL-10 and IL-5 and the expression of Th2,Treg and Th17 cells(r=-0.360,-0.313,-0.269,-0.231,-0.369,-0.306,P<0.05);TF was positively correlated with the levels of IL-6,IL-10 and IL-5 and the expressions of TH2,Treg and Th17 cells(r=0.577,0.490,0.345,0.394,0.507,0.490,P<0.05);it was negatively correlated with the levels of IL-2,IFN-γ,TNF-α,Th1 cell expression and Th1/Th2(r=-0.665,-0.401,-0.590,-0.540,-0.432,P<0.05);Hb was positively correlated with IL-2,TNF-αlevels and Th1 cell expression(r=0.280,0.392,0.194,P<0.05),it was negatively correlated with the levels of IL-6,IL-10 and IL-5 and the expression of Th2,Treg and Th17 cells(r=-0.284,-0.188,-0.308,-0.210,-0.266,-0.327,P<0.05).Conclusion The nutritional indexes of patients with colorectal cancer are correlated with Th1/Th2 immune balance and the correlation of Treg and Th17.With the changes of nutritional indexes of patients with colorectal cancer,Th1/Th2 immune balance and the expression levels of Treg and Th17 will be changed,and the Th1/Th2 immune balance of patients with poor nutritional status will shift to TH2.Treg and Th17 increased,and anti-tumor immunity weakened.