胃癌患者外周血T淋巴细胞亚群、PD-1水平的变化与预后的关系分析-现代医学

胃癌患者外周血T淋巴细胞亚群、PD-1水平的变化与预后的关系分析

单位：盐城市滨海县人民医院肿瘤科, 江苏盐城 224500

分类号：R735.2

出版年·卷·期（页码）：2018·46·第十期（1119-1122）

摘要：

目的：探讨胃癌患者外周血T淋巴细胞亚群、细胞表面程序性死亡受体1（PD-1）水平的变化与预后的关系。方法：选择我院收治的75例初诊胃癌患者设为胃癌组，同期来我院体检的健康人30例设为健康对照组，比较分析胃癌患者外周血T淋巴细胞CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺值及PD-1水平变化与预后的关系。结果：胃癌组患者外周血T淋巴细胞CD₈⁺及PD-1水平明显高于对照组，CD₃⁺、CD₄⁺水平及CD₄⁺/CD₈⁺值明显低于对照组（P<0.05）；死亡组患者外周血T淋巴细胞CD₈⁺及PD-1水平明显高于生存组，CD₃⁺、CD₄⁺水平及CD₄⁺/CD₈⁺值明显低于生存组（P<0.05）；多因素COX风险回归分析显示，外周血CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺值及PD-1水平、年龄、肿瘤分期是胃癌近期预后的独立危险因素；年龄、肿瘤分期、CD₈⁺及PD-1水平与胃癌预后呈正相关，CD₃⁺、CD₄⁺水平及CD₄⁺/CD₈⁺值与胃癌预后呈负相关。结论：胃癌患者的外周血CD₈⁺及PD-1水平明显增加，CD₃⁺、CD₄⁺水平及CD₄⁺/CD₈⁺值明显降低，联合检测PD-1和T淋巴细胞亚群可协助医师评估胃癌患者病情变化，值得临床推广应用。

Objective:To analyze the relationship between peripheral blood T lymphocyte subsets, cell surface programmed death receptor 1 (PD-1) and prognosis in patients with gastric cancer. Methods:Seventy-five patients with gastric cancer were selected as gastric cancer group, and 30 healthy people undergoing physical examination in our hospital were served as control group. The relationship between the changes of CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺ ratio and PD-1 levels in peripheral blood T lymphocytes and the prognosis of gastric cancer patients was analyzed. Results:The levels of CD₈⁺ and PD-1 in peripheral blood T lymphocytes of the gastric cancer group were significantly higher than those in the control group, while the levels of CD₃⁺, CD₄⁺ and CD₄⁺/CD₈⁺ were significantly lower than those of the control group (P<0.05). CD₈⁺ and PD-1 expressions in peripheral blood T lymphocyte of the death group were significantly higher than those in the survival group, while the levels of CD₃⁺,CD₄⁺ and CD₄⁺/CD₈⁺ ratio were significantly lower than those in the survival group (P<0.05). Multiariable COX regression analysis showed that the levels of CD₃⁺, CD₄⁺, CD₈⁺, CD₄⁺/CD₈⁺ ratio in peripheral blood, PD-1, age and tumor stage were independent risk factors for prognosis in patients with gastric cancer. The levels of CD₈₊ and PD-1 were positively correlated with the prognosis of patients with gastric cancer while the levels of CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺ were negatively correlated with the prognosis. Conclusion:CD₈⁺ and PD-1 expressions in T lymphocyte subsets are significantly increased in patients with gastric cancer. Combined detection of the levels of PD-1 and T lymphocyte subsets can effectively assist doctors to assess patients with gastric cancer, which is worth clinical application.

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