肿瘤浸润淋巴细胞CD3^(+)、CD4^(+)T细胞联合IL-17检测对非小细胞肺癌患者预后的预测价值

Prognostic Value of Combined Detection of Tumor-Infiltrating CD3^(+)and CD4^(+)T Cells and IL-17 in Non-Small Cell Lung Cancer

【目的】探讨肿瘤浸润淋巴细胞CD3^(+)、CD4^(+)T细胞联合白细胞介素-17(IL-17)检测对非小细胞肺癌(NSCLC)患者预后的预测价值。【方法】本院收治的132例行肺癌根治术的NSCLC患者,术后随访3年。分析影响患者预后的因素及生存状况,比较无病生存与复发患者CD3^(+)、CD4^(+)T细胞及IL-17表达水平及其与患者预后的关系。【结果】无病生存组患者的CD3^(+)、CD4^(+)T细胞计数均高于复发组(P<0.05),IL-17的阳性表达率低于复发组(P<0.05)。多因素Logistic回归分析显示,肿瘤分期、CD3^(+)和CD4^(+)T细胞计数、IL-17阳性是NSCLC患者治疗后无病生存的影响因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,CD3^(+)和CD4^(+)T细胞、IL-17及三者联合预测NSCLC患者无病生存的灵敏度分别为72.22%、75.93%、70.37%、81.48%,特异度分别为73.44%、71.88%、70.31%、90.63%。CD3^(+)和CD4^(+)T细胞高表达组患者的无病生存曲线均优于低表达组(P<0.05),IL-17阴性表达组的无病生存曲线优于阳性表达组(P<0.05)。【结论】CD3^(+)、CD4^(+)T细胞及IL-17与NSCLC预后有关,三者联合预测患者预后的效能良好,且CD3^(+)、CD4^(+)T细胞低表达者及IL-17阳性表达者预后不良的风险较高。

【Objective】To investigate the prognostic value of combined detection of tumor-infiltrating CD3^(+)and CD4^(+)T cells and interleukin-17(IL-17)in non-small cell lung cancer(NSCLC).【Methods】A total of 132 NSCLC patients who underwent radical lung cancer surgery in our hospital were followed up for 3 years postoperatively.Factors affecting patient prognosis and survival status were analyzed,and the expression levels of CD3^(+)and CD4^(+)T cells and IL-17 were compared between disease-free and recurrent patients,along with their relationship to prognosis.【Results】The counts of CD3^(+)and CD4^(+)T cells in the disease-free group were higher than those in the recurrence group(P<0.05),and the positive expression rate of IL-17 in the disease-free group was lower than that in the recurrence group(P<0.05).Multivariate logistic regression analysis showed that tumor staging,CD3^(+)and CD4^(+)cell counts,and IL-17 positivity were factors affecting disease-free survival in NSCLC patients(P<0.05).Receiver operating characteristic(ROC)curve analysis indicated that the sensitivity of CD3^(+)T cells,CD4^(+)T cells,IL-17,and their combination in predicting disease-free survival in NSCLC patients were 72.22%,75.93%,70.37%,and 81.48%,respectively,and the specificities were 73.44%,71.88%,70.31%,and 90.63%,respectively.The disease-free survival curves for patients with high expression of CD3^(+)and CD4^(+)T cells were better than those for patients with low expression(P<0.05),and the disease-free survival curve for the IL-17 negative expression group was better than that for the IL-17 positive expression group(P<0.05).【Conclusion】The CD3^(+)T cells,CD4^(+)T cells,and IL-17 are associated with the prognosis of NSCLC,and the combined prediction of these three markers has good prognostic value.Patients with low expression of CD3^(+)and CD4^(+)T cells and positive expression of IL-17 have a higher risk of poor prognosis.