冷冻消融治疗软组织肉瘤后外周血T细胞亚群变化与患者生存期的相关性

Changes of peripheral blood T-cell subsets after cryoablationtherapy of soft tissue sarcoma and correlation withpatients' survival

目的 观察冷冻消融治疗软组织肉瘤(STS)后外周血T细胞亚群变化及其与患者生存期的相关性。方法 纳入22例接受冷冻消融治疗的晚期STS患者,比较治疗前、后外周血T细胞亚群变化,分析影响患者生存期的相关因素,以及总生存期(OS)和无进展生存期(PFS)与外周血T细胞亚群变化的相关性。结果 共对22个病灶实施冷冻消融。治疗后疾病客观缓解率为81.82%(18/22),患者中位OS为15个月,中位PFS为7个月。OS与肿瘤病理分级和消融效果相关(P均<0.01)。治疗后外周血CD4^(+)T、Treg细胞较治疗前降低、自然杀伤(NK)细胞较前升高(P均<0.05);患者PFS与NK细胞水平呈正相关(r=0.539,P=0.010),OS与Treg细胞水平呈负相关(r=-0.463,P=0.030),PFS则与治疗前、后外周血CD4^(+)T细胞差值呈正相关(r_(s)=0.424,P=0.049)。结论 冷冻消融治疗STS可在一定程度上改善机体免疫功能;治疗后血清NK、Treg细胞水平可用于评估患者生存期。

Objective To observe changes of peripheral blood T-cell subsets after cryoablation therapy of soft tissue sarcoma(STS)and the correlation with patients survival.Methods Twenty-two patients with advanced STS who underwent cryoablation were enrolled.The changes of peripheral blood T-cell subsets before and after treatment were compared,the impact factors of patients'survival were explored,and the correlations of overall survival(OS)and progression-free survival(PFS)with changes of peripheral blood T-cell subsets were analyzed.Results Cryoablation therapy was performed in 22 lesions.After treatment,the objective remission rate was 81.82%(18/22),with the median OS of 15 months and the median PFS of 7 months.Patients'OS was associated with pathological grading and treatment efficacy(both P<0.01).After cryoablation,CD4^(+)T and Treg cells in peripheral blood were lower,while natural killer(NK)cells were higher than those before treatment(all P<0.05).After treatment,PFS was positively correlated with NK cell level(r=0.539,P=0.010),while OS was negatively correlated with Treg cell level(r=-0.463,P=0.030).PFS was positively correlated with the difference of CD4^(+)T cells in peripheral blood before and after treatment(r_(s)=0.424,P=0.049).Conclusion The immune function of the body could be improved in curtain degree after cryoablation therapy of soft tissue sarcoma.Serum NK and Treg cell levels could be used to evaluate patients'survival after treatment.