淋巴细胞亚群对于不同肿瘤浸润模式胃癌的预后价值

Prognostic value of lymphocyte subsets in gastric cancer with different tumor infiltration patterns

目的:探讨淋巴细胞亚群对于不同肿瘤浸润模式胃癌的预后价值。方法:本研究纳入2014年8月至2016年12月在哈尔滨医科大学附属肿瘤医院接受胃癌根治术的患者,分析不同肿瘤浸润模式的免疫差异。采用Kaplan-Meier法和Log-rank检验分析患者的总体生存情况,COX回归分析评估患者的独立预后因素,最后绘制列线图。结果:浸润模式c的外周血CD4和CD19的中位细胞数为750(94~2 504)个/μl和186(17~820)个/μl,浸润模式a的外周血CD4和CD19的中位细胞数为802(203~2 071)个/μl和213(5~948)个/μl,浸润模式c的外周血CD4和CD19细胞数量低于浸润模式a,差异具有统计学意义(CD4: Z=-3.061, P=0.002;CD19: Z=-2.016, P=0.044)。CD19淋巴细胞( P=0.023)是与浸润模式a、CD8淋巴细胞( P=0.027)是与浸润模式b、CD4淋巴细胞( P=0.026)是与浸润模式c预后相关的独立危险因素,可以构建列线图评估患者的预后。 结论:不同浸润模式类型胃癌患者的外周血淋巴细胞亚群数量存在差异,可以通过淋巴细胞亚群与临床病理特征构建列线图以评估胃癌患者的预后。

Objective To probe into the potential prognostic value of lymphocyte subsets in gastric cancer.Methods This study included patients who underwent radical gastrectomy for gastric cancer from Aug 2014 to Dec 2016.The immunological differences was analyzed in different infiltration patterns.The overall survival of patients was analyzed by Kaplan-Meier method and Log-rank test.COX regression was performed to assess independent prognostic factors of the patients,and finally constructed nomogram.Results The median number of peripheral CD4 and CD19 cells in infiltration pattern c was 750(94-2504)cells/μl and 186(17-820)cells/μl;the median number of peripheral CD4 and CD19 cells in infiltration pattern a was 802(203-2071)cells/μl and 213(5-948)cells/μl,the number of peripheral CD4,CD19 cells in infiltration pattern c was lower than that in infiltration pattern a,with statistically significant differences(CD4:Z=-3.061,P=0.002;CD19:Z=-2.016,P=0.044).CD19 lymphocytes(P=0.023)were associated with infiltration pattern a,CD8 lymphocytes(P=0.027)were associated with infiltration pattern b,and CD4 lymphocytes(P=0.026)were independent risk factors associated with the prognosis of infiltration pattern c.A nomogram can be constructed to evaluate the prognosis of patients.Conclusion There are differences in the number of peripheral lymphocyte subsets in patients with different INF types.A nomogram can be constructed from lymphocyte subsets and clinicopathological features to assess patient prognosis.