目的分析新辅助化疗对食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)患者疗效及CD66b^(+)中性粒细胞、调节性T细胞(regulatory cell,Treg)和调节性B细胞(regulatory B cell,Breg)水平的影响。方法收集2018年1月至2...目的分析新辅助化疗对食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)患者疗效及CD66b^(+)中性粒细胞、调节性T细胞(regulatory cell,Treg)和调节性B细胞(regulatory B cell,Breg)水平的影响。方法收集2018年1月至2019年6月海安市人民医院经胃镜病理活检诊断的122例Ⅱ-Ⅲ期AEG手术患者为研究对象,单纯手术治疗者设为对照组(63例),联合新辅助化疗者为实验组(59例)。采用卡式功能(Karnofsky,KPS)评分评价治疗效果;免疫组织化学染色对肿瘤病灶的CD66b^(+)中性粒细胞进行计数;流式细胞仪检测Treg、Breg及CD3^(+)、CD4^(+)、CD8^(+)细胞水平,根据随访结果分析患者生存情况,采用Spearman相关性分析患者的生存状况与肿瘤组织Treg细胞、Breg细胞、CD66b^(+)中性粒细胞的相关性,统计治疗期间患者不良反应发生情况。结果经过治疗后,实验组和对照组KPS评分均升高,且实验组KPS评分高于对照组,差异具有统计学意义[分:(85.59±1.27)比(82.33±1.33),t=13.85,P<0.05)];实验组CD66b^(+)中性粒细胞计数低于对照组[109/L:(5.66±1.47)比(8.75±1.15),t=12.87,P<0.05)];实验组和对照组患者的Treg细胞和Breg细胞比例均下降,且实验组患者的Treg细胞和Breg细胞低于对照组[%:(2.05±0.21)比(3.11±0.23);(3.05±0.80)比(4.68±0.76),t值分别为26.61和11.52,P值均<0.05)];实验组肿瘤组织的CD3^(+)、CD4^(+)细胞水平高于对照组,CD8^(+)细胞低于对照组,差异均具有统计学意义[%:(0.99±0.21)比(0.78±0.12),(0.68±0.23)比(0.37±0.09),(0.44±0.04)比(0.64±0.12),t值分别为6.72、9.68和12.51,P值均<0.05)];实验组患者中位总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)均高于对照组[月:(12.77±2.08)比(10.04±2.01),(9.62±1.24)比(7.43±1.11),t值分别为34.34、10.25,P值均<0.05)];实验组和对照组患者不良反应发生率的差异无统计学意义(P>0.05)。结论AEG患者术前采用新辅助化疗较对照组CD66b^(+)中性粒细胞、Treg细胞和Breg细胞比例降低,治疗效果良好,建议推广。展开更多
Background:With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation(UCBT),the correlation between immune reconstitution(IR)after UCBT and graft-vers...Background:With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation(UCBT),the correlation between immune reconstitution(IR)after UCBT and graft-versus-host disease(GVHD)has been reported successively,but reports on double-negative T(DNT)cell reconstitution and its association with acute GVHD(aGVHD)after UCBT are lacking.Methods:A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology,the First Affiliated Hospital of USTC,between August 2018 and June 2021.IR differences were compared between the patients with and without aGVHD.Results:The absolute number of DNT cells in the healthy Chinese population was 109(70-157)/μL,accounting for 5.82(3.98-8.19)%of lymphocytes.DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation.Importantly,the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year(F=4.684,P=0.039 and F=5.583,P=0.026,respectively).In addition,the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased,and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD(HR=0.46,95%confidence interval[CI]:0.23-0.93;P=0.031).Conclusions:Compared to the number of DNT cells in Chinese healthy people,the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow.In addition,the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.展开更多
文摘目的分析新辅助化疗对食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)患者疗效及CD66b^(+)中性粒细胞、调节性T细胞(regulatory cell,Treg)和调节性B细胞(regulatory B cell,Breg)水平的影响。方法收集2018年1月至2019年6月海安市人民医院经胃镜病理活检诊断的122例Ⅱ-Ⅲ期AEG手术患者为研究对象,单纯手术治疗者设为对照组(63例),联合新辅助化疗者为实验组(59例)。采用卡式功能(Karnofsky,KPS)评分评价治疗效果;免疫组织化学染色对肿瘤病灶的CD66b^(+)中性粒细胞进行计数;流式细胞仪检测Treg、Breg及CD3^(+)、CD4^(+)、CD8^(+)细胞水平,根据随访结果分析患者生存情况,采用Spearman相关性分析患者的生存状况与肿瘤组织Treg细胞、Breg细胞、CD66b^(+)中性粒细胞的相关性,统计治疗期间患者不良反应发生情况。结果经过治疗后,实验组和对照组KPS评分均升高,且实验组KPS评分高于对照组,差异具有统计学意义[分:(85.59±1.27)比(82.33±1.33),t=13.85,P<0.05)];实验组CD66b^(+)中性粒细胞计数低于对照组[109/L:(5.66±1.47)比(8.75±1.15),t=12.87,P<0.05)];实验组和对照组患者的Treg细胞和Breg细胞比例均下降,且实验组患者的Treg细胞和Breg细胞低于对照组[%:(2.05±0.21)比(3.11±0.23);(3.05±0.80)比(4.68±0.76),t值分别为26.61和11.52,P值均<0.05)];实验组肿瘤组织的CD3^(+)、CD4^(+)细胞水平高于对照组,CD8^(+)细胞低于对照组,差异均具有统计学意义[%:(0.99±0.21)比(0.78±0.12),(0.68±0.23)比(0.37±0.09),(0.44±0.04)比(0.64±0.12),t值分别为6.72、9.68和12.51,P值均<0.05)];实验组患者中位总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)均高于对照组[月:(12.77±2.08)比(10.04±2.01),(9.62±1.24)比(7.43±1.11),t值分别为34.34、10.25,P值均<0.05)];实验组和对照组患者不良反应发生率的差异无统计学意义(P>0.05)。结论AEG患者术前采用新辅助化疗较对照组CD66b^(+)中性粒细胞、Treg细胞和Breg细胞比例降低,治疗效果良好,建议推广。
基金National Natural Science Foundation of China(Nos.82270223,82170209,and 82100230)Anhui Provincial Key Research and Development Project(No.2022e07020015)+1 种基金Anhui Health Research Project(No.AHWJ2022a 011)Fundamental Research Funds for the Central Universities(Nos.WK9110000204,and WK9110000168)
文摘Background:With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation(UCBT),the correlation between immune reconstitution(IR)after UCBT and graft-versus-host disease(GVHD)has been reported successively,but reports on double-negative T(DNT)cell reconstitution and its association with acute GVHD(aGVHD)after UCBT are lacking.Methods:A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology,the First Affiliated Hospital of USTC,between August 2018 and June 2021.IR differences were compared between the patients with and without aGVHD.Results:The absolute number of DNT cells in the healthy Chinese population was 109(70-157)/μL,accounting for 5.82(3.98-8.19)%of lymphocytes.DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation.Importantly,the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year(F=4.684,P=0.039 and F=5.583,P=0.026,respectively).In addition,the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased,and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD(HR=0.46,95%confidence interval[CI]:0.23-0.93;P=0.031).Conclusions:Compared to the number of DNT cells in Chinese healthy people,the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow.In addition,the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.
