摘要
为探讨不同分期结肠癌患者外周血T细胞表面PD-1表达水平及其与免疫治疗疗效的关系,采集112例结肠癌患者作为研究对象,分析PD-1表达与患者临床特征的关系;根据免疫治疗疗效将患者分为有效组(85例)和无效组(27例),采用多因素Logistic回归分析检验PD-1表达与患者临床分期的关系及影响免疫治疗疗效的因素。结果显示,不同临床分期间、不同癌胚抗原(carcinoembryonic antigen,CEA)水平间、不同糖类抗原199(carbohydrate antigen 199,CA199)水平间患者的PD-1阳性表达率差异显著(均P<0.05);多因素Logistic分析结果显示,PD-1阳性表达率不能作为患者临床分期的独立预测指标(P>0.05);低/中低分化、临床分期Ⅲ~Ⅳ期、淋巴结转移、远处转移、中性粒细胞-淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)≥5、血小板-淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)≥135和PD-1阳性表达是提示患者免疫治疗无效的危险因素(均P<0.05)。该研究提示,外周血T细胞表面PD-1表达与结肠癌患者临床分期及免疫治疗疗效显著关联,但尚不能作为临床分期的独立预测指标,可作为预测免疫治疗疗效的生物学指标。
The study aims to investigate the expression level of PD-l on peripheral blood T cells among colon cancer patients with different stages and its connection with immunotherapy efficacy.One hundred and twelve colon cancer patients were enrolled in to analyze the relationship between PD-1 expression and clinical parameters.Based on the outcome of immunotherapy,the patients were divided into the effective group(n=85)and the ineffective group(n=27).Multivariate logistic regression formula was used to analyze the relationship between PD-1 expression and clinical characteristics and to screen the factors affecting the efficacy of immunotherapy in the objects.The results showed that there existed statistically significant differences in PD-1 expression among different clinical stages,and among different expression levels of carcinoembryonic antigen(CEA)or carbohydrate antigen 199(CA199)(all with P<0.05).However,the results of multivariate logistic analysis showed that the positive expression rate of PD-1 could not be used as an independent predictor for clinical staging(P>0.05);Low/middle-low differentiation,clinical stage II-IV,lymph node metastasis,distant metastasis,neutrophil-to-lymphocyte ratio(NLR)≥5,platelet-to-lymphocyte ratio(PLR)≥135,and positive expression of PD-1 all were risk factors predicting ineffective immuno-therapy in colon cancer patients(all with P<0.05).This study suggests that the expression of PD-1 on CD4+T cells in peripheral blood is significantly associated with clinical stages and the efficacy of immunotherapy in colon cancer patients.However,it can not be used as an independent predictor for clinical staging.Meanwhile,PD-1 is sufficient to be used as a biological index for predicting the efficacy of immunotherapy.
作者
徐中海
吕耀斗
张占蛟
李晓军
刘光耀
XU Zhonghai;LYU Yaodou;ZHANG Zhanjiao;LI Xiaojun;LIU Guangyao(Department of Pathology,Nanjing Kingmed Diagnostics Co.Ltd,Nanjing 210000,China;Department of Pathology,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 225300,China)
出处
《现代免疫学》
2025年第4期448-456,共9页
Current Immunology
关键词
结肠癌
临床分期
免疫治疗
程序性死亡受体1
临床疗效
colon cancer
clinical staging
immunotherapy
programmed death l
clinical therapeutic efficacy
作者简介
徐中海(1985-),男,博士,副主任医师,主要从事肿瘤诊断与治疗相关研究;通信作者:刘光耀,E-mail:44887358@qq.com。
