摘要
目的探讨Ⅲ期结直肠癌5-Fu为主的辅助化疗过程中CD24在免疫微环境分布变化及与预后的关系。方法选取2017年1月至2022年6月在我院接受治疗的148例行以5-Fu为主的辅助化疗的Ⅲ期结直肠癌患者为研究对象。流式细胞法分析血液中CD24^(+)表达情况。依据患者预后情况分为预后不良组(n=42)和预后良好组(n=106),比较两组患者的一般资料及化疗前后肿瘤免疫微环境变化。多因素Logistic回归分析影响预后不良发生的危险因素。建立列线图模型并进行评价。结果辅助化疗治疗后6个月,CD24^(+)的水平较治疗前明显降低(P<0.05)。肿瘤浸润深度,淋巴结转移,治疗后6个月CD10^(+)及CD24^(+)水平升高,CD3^(+)、CD4^(+)、CD8^(+)水平降低是Ⅲ期结直肠癌患者预后不良的危险因素(P<0.05)。依据独立影响因素构建的列线图预测模型具有较高的区分度、准确性和临床适用性。结论5-Fu为主的辅助化疗后,CD24^(+)的平均阳性率较治疗前明显降低,可用于预测患者的预后。结合患者临床特征构建的预测模型可有效预测Ⅲ期结直肠癌患者的预后情况。
Objective To investigate the relationship between the distribution of CD24 in immune microenvironment and prognosis of stageⅢcolorectal cancer during 5-Fu-based adjuvant chemotherapy.Methods From Jan.2017 to Jun.2022,148 patients with stageⅢcolorectal cancer who received adjuvant chemotherapy with 5-Fu as the research object.The expression of CD24^(+)in blood was analyzed by flow cytometry.According to the prognosis,the patients were divided into two groups:poor prognosis group(n=42)and good prognosis group(n=106).The general data of the two groups and the changes of tumor immune microenvironment before and after chemotherapy were compared.Multivariate Logistic regression analysis was used to analyze the risk factors of poor prognosis.The nomogram model was established and evaluated.Results After 6 months of adjuvant chemotherapy,the average positive rate of CD24^(+)was significantly decreased(P<0.05).Tumor invasion depth,lymph node metastasis,increased CD10^(+)and CD24^(+)levels and decreased CD3^(+),CD4^(+)and CD8^(+)levels 6 months after treatment were risk factors for poor prognosis in stageⅢcolorectal cancer patients(P<0.05).The nomogram prediction model based on independent influencing factors had high differentiation,accuracy and clinical applicability.Conclusion After 5-Fu-based adjuvant chemotherapy,the average positive rate of CD24^(+)is significantly lower than that before treatment,which can be used to predict the prognosis of patients.The prediction model combined with the clinical characteristics of patients can effectively predict the prognosis of patients with stageⅢcolorectal cancer.
作者
李珊
黄红艳
LI Shan;HUANG Hongyan(Department of Medical Oncology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《胃肠病学和肝病学杂志》
CAS
2024年第6期732-739,共8页
Chinese Journal of Gastroenterology and Hepatology
关键词
结直肠癌
辅助化疗
免疫细胞
肿瘤微环境
预后
Colorectal cancer
Adjuvant chemotherapy
Immune cells
Tumor microenvironment
Prognosis
