T淋巴细胞亚群、IL-6在胃癌患者中的表达及其与预后的相关性

Expression of T lymphocyte subsets and IL-6 in patients with gastric cancer and their correlation with prognosis

目的分析外周血T淋巴细胞亚群及白细胞介素-6(interleukin-6,IL-6)在胃癌患者中的表达,探究其与预后的相关性。方法选取2021年6月至2023年6月连云港市第二人民医院收治的106例胃癌患者为试验组,入院次日检测其外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))及IL-6水平。选取同时段于连云港市第二人民医院进行体检的健康者80例为对照组,体检当日检测其外周血T淋巴细胞亚群及IL-6水平。比较两组T淋巴细胞亚群及IL-6水平。胃癌患者院外随访6个月,根据患者死亡、存活情况将其分为预后不良组(17例)、预后良好组(89例)。预后不良组男10例(58.82%),女7例(41.18%),年龄(60.47±5.89)岁;文化程度:中学及以上9例(52.94%),中学以下8例(47.06%)。预后良好组男55例(61.80%),女34例(38.20%),年龄(60.08±5.71)岁;文化程度:中学及以上32例(35.96%),中学以下57例(64.04%)。logistic回归分析影响胃癌患者预后的因素。采用受试者操作特征曲线(ROC)评估外周血T淋巴细胞亚群及IL-6预测胃癌患者预后的价值。采用t检验和χ^(2)检验。结果试验组CD3^(+)、CD4^(+)水平低于对照组[(55.27±8.72)%比(68.97±6.45)%、(26.42±10.21)%比(38.12±5.07)%],CD8^(+)、IL-6水平高于对照组[(33.36±6.02)%比(24.66±3.75)%、(6.97±3.29)ng/L比(3.62±1.01)ng/L],差异均有统计学意义(t=-11.821、-9.413、11.360、8.803,均P<0.05)。预后不良组CD3^(+)、CD4^(+)水平低于预后良好组[(45.12±10.06)%比(57.21±6.97)%、(20.01±10.12)%比(27.64±9.81)%],CD8^(+)、IL-6水平、肿瘤分期Ⅳ期患者占比高于预后良好组[(40.12±6.01)%比(32.07±5.12)%、(9.75±3.16)ng/L比(6.44±3.05)ng/L、70.59%(12/17)比32.58%(29/89)],差异有统计学意义(t=-6.068、-2.924、5.774、4.077,χ^(2)=8.692,均P<0.05)。logistic回归分析显示,肿瘤分期、CD3^(+)、CD8^(+)、IL-6水平是影响胃癌患者预后的因素(均P<0.05)。CD3^(+)、CD8^(+)、IL-6预测患者预后不良的ROC下面积分别为0.847、0.853、0.768。结论胃癌患者CD3^(+)、CD4^(+)低表达,CD8^(+)及IL-6高表达。CD3^(+)、CD8^(+)、IL-6水平是影响胃癌患者预后的因素。

Objective To analyze the expression of peripheral blood T lymphocyte subsets and interleukin-6(IL-6)in patients with gastric cancer,and to explore their correlation with prognosis.Methods A total of 106 patients with gastric cancer treated at Lianyungang Second People's Hospital from June 2021 to June 2023 were selected as an experimental group,and their peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),and CD8^(+))and IL-6 levels were detected the day after they were admitted to the hospital.Eighty healthy people who came to the hospital for physical examination at the same time were selected as a control group,and their peripheral blood T lymphocyte subsets and IL-6 levels were detected on the day of physical examination.The T lymphocyte subsets and IL-6 levels were compared between the two groups.The patients were followed up 6 months after discharge,and were divided into a poor prognosis group(17 cases)and a good prognosis group(89 cases)according to death and survival.There were 10 males(58.82%)and 7 females(41.18%)in the poor prognosis group;they were(60.47±5.89)years old;9 cases'(52.94%)education level was middle school or above,and 8 cases'(47.06%)below middle school.In the good prognosis group,there were 55 males(61.80%)and 34 females(38.20%);they were(60.08±5.71)years old;32 cases'(35.96%)education level was middle school or above,and 57 cases'(64.04%)below middle school.The logistic regression analysis was done for the prognostic factors in the patients.The receiver operating characteristic curves(ROC)were drawn to evaluate the values of peripheral blood T lymphocyte subsets and IL-6 in the prediction of the patients'prognosis.t andχ^(2) were applied.Results The levels of CD3^(+)and CD4^(+)in the experimental group were lower than those in the control group[(55.27±8.72)%vs.(68.97±6.45)%and(26.42±10.21)%vs.(38.12±5.07)%];the levels of CD8^(+)and IL-6 in the experimental group were higher than those in the control group[(33.36±6.02)%vs.(24.66±3.75)%and(6.97±3.29)ng/L vs.(3.62±1.01)ng/L];there were statistical differences(t=-11.821,-9.413,11.360,and 8.803;all P<0.05).The levels of CD3^(+)and CD4^(+)in the poor prognosis group were lower than those in the good prognosis group[(45.12±10.06)%vs.(57.21±6.97)%and(20.01±10.12)%vs.(27.64±9.81)%];the levels of CD8^(+)and IL-6 and the proportion of the patients of tumor stageⅣin the poor prognosis group were higher than those in the good prognosis group[(40.12±6.01)%vs.(32.07±5.12)%,(9.75±3.16)ng/L vs.(6.44±3.05)ng/L,and 70.59%(12/17)vs.32.58%(29/89)];there were statistical differences(t=-6.068,-2.924,5.774,and 4.077;χ^(2)=8.692;all P<0.05).The logistic regression analysis showed that tumor stage and CD3^(+),CD8^(+),and IL-6 levels were the factors influencing the patients'prognosis(all P<0.05).The areas under the ROC's of CD3^(+),CD8^(+),and IL-6 for predicting the patients'adverse prognosis were 0.847,0.853,and 0.768,respectively.Conclusions In patients with gastric cancer,the levels of CD3^(+)and CD4^(+)are low,and the levels of CD8^(+)and IL-6 are high.The levels of CD3^(+),CD8^(+),and IL-6 affect the prognosis of patients with gastric cancer.