Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy ...Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they generally decreased after cCRT.A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.展开更多
目的观察局部巨块型宫颈癌(locally advanced bulky cervical cancer,LABCC)患者手术治疗的疗效,并分析相关预后指标,为临床实践提供参考。方法选取我中心妇产科2013年1月-2015年1月手术治疗的354例宫颈癌(ⅠA2-ⅡA2期)患者作为研究对...目的观察局部巨块型宫颈癌(locally advanced bulky cervical cancer,LABCC)患者手术治疗的疗效,并分析相关预后指标,为临床实践提供参考。方法选取我中心妇产科2013年1月-2015年1月手术治疗的354例宫颈癌(ⅠA2-ⅡA2期)患者作为研究对象。根据国际妇产科联合会2009分期标准,将ⅠB2期(n=57)和ⅡA2期(n=34)局部病灶≥4 cm病例纳入LABCC组,将ⅠA2期(n=12)、ⅠB1期(n=189)和ⅡA1期(n=62)局部病灶<4 cm病例纳入对照组,比较两组围术期指标、并发症发生情况和生存指标。结果 LABCC组纳入91例,平均年龄(52.4±5.5)岁;对照组纳入263例患者,平均年龄(51.8±4.8)岁。LABCC组接受新辅助化疗比例高于对照组[69例(75.8%) vs 45例(17.1%),P<0.001],术中出血量[(598.1±135.3) ml vs (450.8±117.5) ml,P<0.001]和输血率[11例(12.1%) vs 14例(5.3%),P=0.030]高于对照组,术后住院时间长于对照组[(14.1±1.4) d vs (12.1±1.5) d,P<0.001],泌尿系损伤发生率高于对照组[5例(5.5%) vs 4例(1.5%),P=0.038];两组手术用时、淋巴结切除数以及其他并发症发生率无统计学差异(P>0.05)。LABCC组的5年累积生存率低于对照组(64.8% vs 82.1%,P=0.001),死亡率高于对照组(9.9% vs 4.2%,P=0.042),两组复发率差异无统计学意义(14.3% vs8.4%,P=0.103)。结论手术治疗LABCC疗效可靠,建议在新辅助化疗后进行手术,LABCC组较对照组5年生存率更低、死亡率更高。展开更多
基金the National Key Research and Development Program of China(No:2016YFC1302904)the National Natural Science Foundation of China(No:81572559)the Key Research Project of Shandong Province(No:2017CXGC1210).
文摘Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they generally decreased after cCRT.A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.
文摘目的观察局部巨块型宫颈癌(locally advanced bulky cervical cancer,LABCC)患者手术治疗的疗效,并分析相关预后指标,为临床实践提供参考。方法选取我中心妇产科2013年1月-2015年1月手术治疗的354例宫颈癌(ⅠA2-ⅡA2期)患者作为研究对象。根据国际妇产科联合会2009分期标准,将ⅠB2期(n=57)和ⅡA2期(n=34)局部病灶≥4 cm病例纳入LABCC组,将ⅠA2期(n=12)、ⅠB1期(n=189)和ⅡA1期(n=62)局部病灶<4 cm病例纳入对照组,比较两组围术期指标、并发症发生情况和生存指标。结果 LABCC组纳入91例,平均年龄(52.4±5.5)岁;对照组纳入263例患者,平均年龄(51.8±4.8)岁。LABCC组接受新辅助化疗比例高于对照组[69例(75.8%) vs 45例(17.1%),P<0.001],术中出血量[(598.1±135.3) ml vs (450.8±117.5) ml,P<0.001]和输血率[11例(12.1%) vs 14例(5.3%),P=0.030]高于对照组,术后住院时间长于对照组[(14.1±1.4) d vs (12.1±1.5) d,P<0.001],泌尿系损伤发生率高于对照组[5例(5.5%) vs 4例(1.5%),P=0.038];两组手术用时、淋巴结切除数以及其他并发症发生率无统计学差异(P>0.05)。LABCC组的5年累积生存率低于对照组(64.8% vs 82.1%,P=0.001),死亡率高于对照组(9.9% vs 4.2%,P=0.042),两组复发率差异无统计学意义(14.3% vs8.4%,P=0.103)。结论手术治疗LABCC疗效可靠,建议在新辅助化疗后进行手术,LABCC组较对照组5年生存率更低、死亡率更高。