摘要
目的:探讨乳腺癌新辅助治疗(NAT)过程中CD24在免疫微环境中的分布变化及其与腋窝淋巴结病理状态的关系。方法:选取2021年2月至2024年2月郴州市第一人民医院收治的乳腺癌患者200例为研究对象,根据患者CD24表达分为高表达组(n=126)和低表达组(n=74),根据临床治疗效果分为完全缓解组(pCR组,n=91)和非pCR组(n=109)。采用分层回归模型分析不同临床病理特征对CD24表达的影响,构建广义线性混合模型判断CD24与pCR的关系,限制性立方样条法分析CD24与pCR的剂量反应关系,采用GMDR模型分析CD24与免疫微环境因子对pCR的交互作用。结果:CD24表达与TNM分期、脉管浸润、淋巴结数量以及肿瘤标志物水平相关。NAT后患者CD24 mRNA水平呈逐渐降低趋势,与治疗前相比,治疗后1个月、3个月、6个月CD24 mRNA表达差异有统计学意义(P<0.05),体内免疫微环境因子水平均显著变化,CD3^(+)T、CD4^(+)T、CD8^(+)T、FOXP3、IL-10、IgG、IgM水平升高,CD10^(+)T、IL-6、IL-17水平下降。TNM分期、脉管浸润、淋巴结数量、CA125以及CEA水平与CD24水平呈显著正相关(P<0.05)。肿瘤纵横比、TNM分期、脉管浸润、淋巴结数量、HER-2、Ki-67、CD24表达、CD24 mRNA水平与乳腺癌患者NAT后腋窝淋巴结pCR相关,CD24 mRNA表达是NAT后腋窝淋巴结pCR的危险因素,随着CD24 mRNA表达上升,患者pCR概率显著下降。CD24与CD3^(+)T、CD4^(+)T、CD8^(+)T、CD10^(+)T、FOXP3、IL-6、IL-10、IL-17、IgG、IgM对pCR存在交互作用。结论:NAT后患者CD24水平呈逐渐降低趋势,CD24 mRNA表达是NAT后腋窝淋巴结pCR的危险因素,随着CD24 mRNA表达上升,患者pCR概率显著下降。
Objective:To study distribution of CD24 in immune microenvironment and its relationship between pathological status of axillary lymph nodes during neoadjuvant therapy(NAT)for breast cancer.Methods:A total of 200 breast cancer patients admitted to the First People's Hospital of Chenzhou City from February 2021 to February 2024 were selected as research objects.According to CD24 expression,patients were divided into high expression group(n=126)and low expression group(n=74),and divided into pCR group(n=91)and non-pCR group(n=109)according to clinical treatment effect.Hierarchical regression model was used to analyze influence of different clinicopathological features on CD24 expression,generalized linear mixed model was constructed to judge relationship between CD24 and pCR,and dose-response relationship between CD24 and pCR was analyzed by restricted cubic spline method,GMDR model was used to analyze interaction of CD24 and immune microenvironment factors on pCR.Results:CD24 expression was correlated with TNM stage,vascular invasion,number of lymph nodes and tumor markers levels.CD24 mRNA level in patients after NAT showed a gradually decreasing trend.Compared with before treatment,CD24 mRNA expression at 1 month,3 months and 6 months after treatment had statistical significance(P<0.05),immune microenvironment factors levels in patients were signifi-cantly changed,and CD3^(+)T,CD4^(+)T,CD8^(+)T,FOXP3,IL-10,IgG and IgM levels were increased,while CD10^(+)T,IL-6 and IL-17 levels were decreased.TNM stage,vascular invasion,number of lymph nodes,CA125 and CEA levels were significant positive related with CD24 level(P<0.05).Tumor aspect ratio,TNM stage,vascular invasion,number of lymph nodes,HER-2,Ki-67,CD24 expres-sions and CD24 mRNA level were correlated with post-NAT axillary lymph node pCR in breast cancer patients.CD24 mRNA expres-sion was a risk factor for post-NAT axillary lymph node pCR,and probability of pCR in patients decreased significantly with increase of CD24 mRNA expression.CD24 interacted with CD3^(+)T,CD4^(+)T,CD8^(+)T,CD10^(+)T,FOXP3,IL-6,IL-10,IL-17,IgG and IgM on pCR.Conclusion:CD24 level in patients after NAT showes a gradually decreasing trend.CD24 mRNA expression is a risk factor for axillary lymph node pCR after NAT.With increase of CD24 mRNA expression,probability of pCR in patients decreases significantly.
作者
黄海华
何启强
HUANG Haihua;HE Qiqiang(School of Public Health,Wuhan University,Wuhan 430071,China;Imaging Medical Center of the First People's Hospital of Chenzhou City,Chenzhou 423000,China)
出处
《中国免疫学杂志》
北大核心
2025年第8期1958-1964,共7页
Chinese Journal of Immunology
基金
湖南创新型省份建设专项(2023JJ50386)。
关键词
乳腺癌
新辅助治疗
CD24
免疫微环境
腋窝淋巴结
Breast cancer
Neoadjuvant therapy
CD24
Immune microenvironment
Axillary lymph nodes
作者简介
黄海华,男,在读硕士,副主任医师,主要从事乳腺癌流行病学研究,E-mail:Hhh8285@163.com;通信作者:何启强,男,博士,教授,主要从事流行病与统计学研究,E-mail:heqiqiang@gmail.com。
