新辅助治疗后外周血双阴性T细胞比例与进展期直肠癌预后的关系研究

A study on the relationship between double-negative T cells ratio in peripheral blood and prognosis of advanced rectal cancer after neoadjuvant therapy

目的探究新辅助治疗后外周血双阴性T细胞(DNT)比例与进展期直肠癌预后的关系。方法回顾性收集2017年1月至2021年12月山西省肿瘤医院结直肠外科收治的219例直肠癌患者的临床资料,采集其新辅助治疗后的DNT比例指标,取中位数为截断值,将其分为DNT高水平组(DNT≥3%)125例和DNT低水平组(DNT<3%)94例,比较两组TNM分期、病理肿瘤退缩分级(TRG)、神经脉管侵犯、生存预后等指标。结果两组性别、年龄、体质量指数、肿瘤下界距肛门距离、术前肿瘤分期(cT分期、cN分期)、直肠周围筋膜侵犯情况比较差异无统计学意义(P>0.05)。相较于DNT高水平组,DNT低水平组患者的神经脉管侵犯率较低(P=0.014),且有更好的生存预后(P=0.014)。结论新辅助治疗后外周血DNT比例与直肠癌患者的神经脉管侵犯及生存预后显著相关。DNT低水平组患者的神经脉管侵犯率更低,总体生存期更长。

Objective To explore the relationship between double-negative T cells(DNT)ratio in peripheral blood and prognosis of advanced rectal cancer after neoadjuvant therapy.Methods The clinical data of 219 patients with rectal cancer who were admitted to the Department of Colorectal Surgery of Shanxi Cancer Hospital from January 2017 to December 2021 were retrospectively collected.The indicator of DNT ratio of the patients after neoadjuvant therapy was collected,and the median value was taken as the cut-off value,and the patients were divided into high level DNT group(DNT≥3%,125 cases)and low level DNT group(DNT<3%,94 cases).The indicators of TNM stage,pathological tumor regression grade(TRG),neurovascular invasion and survival prognosis were compared between the two groups.Results There were no significant differences in gender,age,body mass index,distance from tumor lower bound to the anus,preoperative tumor stage(cT stage,cN stage),and perirectal fascia invasion between the two groups(P>0.05).Compared with the patients in the high level DNT group,the patients in the low level DNT group had lower rate of neurovascular invasion(P=0.014),and better survival prognosis(P=0.014).Conclusion After neoadjuvant therapy,DNT ratio in peripheral blood is significantly correlated with neurovascular invasion and survival prognosis of the patients with rectal cancer.The patients in the low level DNT group have a lower rate of neurovascular invasion and a longer overall survival period.