【摘要】：背景與目的:中晚期宮頸鱗癌同期放化療(concurrent chemoradiotherapy,CCRT)治療前性?xún)r(jià)比高的療效判斷方法較有限,該研究擬通過(guò)檢測(cè)治療前外周血CD4+CD25+CD127Low/-調(diào)節(jié)性T細(xì)胞(regulatory T cells,Tregs)亞群計(jì)數(shù)及血清鱗癌抗原(squamous cell carcinoma antigen,SCC-Ag)水平,評(píng)價(jià)兩者預(yù)測(cè)臨床療效的可行性。方法:采集44例ⅡB~ⅣA期宮頸鱗癌患者行CCRT治療前的外周血標(biāo)本,分別利用流式細(xì)胞免疫表型分析和酶聯(lián)免疫法檢測(cè)外周血CD4+CD25+CD127Low/-Treg計(jì)數(shù)及血清SCC-Ag水平。收集臨床和病理資料,并統(tǒng)計(jì)檢驗(yàn)2個(gè)指標(biāo)對(duì)療效的預(yù)測(cè)作用。結(jié)果:治療前外周血CD4+CD25+CD127Low/-Treg計(jì)數(shù)在臨床有效組低于無(wú)效組[(8.78±2.80)%vs(10.95±2.56)%,P0.05],血清SCC-Ag在不同臨床療效組間差異無(wú)統(tǒng)計(jì)學(xué)意義,且這2個(gè)指標(biāo)之間未發(fā)現(xiàn)相關(guān)性(Spearman’rho=-0.093,P=0.540)。經(jīng)受試者工作特征(receiver operating characteristic,ROC)曲線確定治療前外周血CD4+CD25+CD127Low/-Treg及血清SCC-Ag最佳界值分別為9.76%與9.50 ng/m L。單因素分析顯示,治療前外周血CD4+CD25+CD127Low/-Treg計(jì)數(shù)(OR=1.901,95%CI:1.112~3.219,P=0.017)對(duì)CCRT療效有預(yù)測(cè)作用,而血清SCC-Ag水平無(wú)預(yù)測(cè)作用(OR=0.998,95%CI:0.001~4.253,P=0.897)。多因素Logistic回歸分析顯示,治療前外周血CD4+CD25+CD127Low/-Treg為獨(dú)立的臨床療效預(yù)測(cè)因子(OR=3.115,95%CI:1.253~7.742,P=0.014)。結(jié)論:治療前外周血CD4+CD25+CD127Low/-Treg計(jì)數(shù)用于中晚期宮頸鱗癌患者CCRT臨床療效預(yù)測(cè)具有可行性。
[Abstract]:Background & objective: the method of evaluating the performance-price ratio of advanced cervical carcinoma with concurrent radiotherapy and chemotherapy (concurrent chemoradiotherapy,CCRT) is limited. This study aims to detect (regulatory T cells, of CD4 CD25 CD127Low/- regulatory T cells in peripheral blood before treatment. The feasibility of predicting clinical efficacy was evaluated by the count of Tregs) subsets and the level of serum squamous cell carcinoma antigen (squamous cell carcinoma antigen,SCC-Ag). Methods: peripheral blood samples were collected from 44 patients with stage II B ~ IV A cervical squamous cell carcinoma before CCRT treatment. Flow cytometry and enzyme linked immunosorbent assay (Elisa) were used to detect CD4 CD25 CD127Low/-Treg count and serum SCC-Ag level in peripheral blood. The clinical and pathological data were collected and the predictive effects of the two indexes on the curative effect were statistically tested. Results: the CD4 CD25 CD127Low/-Treg count of peripheral blood in the clinical effective group was lower than that in the ineffective group [(8.78 鹵2.80)% vs (10.95 鹵2.56)%, P 0.05]. There was no significant difference in serum SCC-Ag among different clinical efficacy groups. No correlation was found between the two indexes (Spearman'rho=-0.093,P=0.540). The optimal boundary values of CD4 CD25 CD127Low/-Treg and SCC-Ag in peripheral blood before treatment were 9.76% and 9.50 ng/m 路L ~ (- 1), respectively, according to the working characteristic CD4 CD25 CD127Low/-Treg) curve of the subjects. Univariate analysis showed that CD4 CD25 CD127Low/-Treg count (OR=1.901,95%CI:1.112~3.219,P=0.017) in peripheral blood before treatment could predict the curative effect of CCRT, but serum SCC-Ag level had no predictive effect (OR=0.998,95%CI:0.001~4.253,). P 鈮，

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