中晚期宫颈鳞癌患者治疗前外周血Treg计数分析

doi:10.3969/j.issn.1007-3969.2015.04.001

中国癌症杂志 ›› 2015, Vol. 25 ›› Issue (4): 241-246.doi: 10.3969/j.issn.1007-3969.2015.04.001

中晚期宫颈鳞癌患者治疗前外周血Treg计数分析

郑雨薇¹，黄啸²，郭林³，杨文韬¹，吴佳文¹，平波¹

1. 复旦大学附属肿瘤医院病理科，复旦大学上海医学院肿瘤学系，上海 200032 ；
2. 复旦大学附属肿瘤医院妇瘤科，复旦大学上海医学院肿瘤学系，上海 200032 ；
3. 复旦大学附属肿瘤医院检验科，复旦大学上海医学院肿瘤学系，上海 200032

出版日期:2015-04-30 发布日期:2015-05-25
通信作者: 平波　E-mail:bping@shca.org.cn
基金资助:
国家自然科学基金青年科学基金资助项目(81101956/H1621)。

Pre-treatment circulating regulatory T cell count analysis of advanced cervical squamous cell carcinoma patients

ZHENG Yuwei¹, HUANG Xiao², GUO Lin³, YANG Wentao¹, WU Jiawen¹, PING Bo¹

1.Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2.Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 3.Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Published:2015-04-30 Online:2015-05-25
Contact: PING Bo E-mail: bping@shca.org.cn

摘要/Abstract

摘要： 　背景与目的：中晚期宫颈鳞癌同期放化疗(concurrent chemoradiotherapy，CCRT)治疗前性价比高的疗效判断方法较有限，该研究拟通过检测治疗前外周血CD4⁺CD25⁺CD127^Low/-调节性T细胞(regulatory T cells，Tregs)亚群计数及血清鳞癌抗原(squamous cell carcinoma antigen，SCC-Ag)水平，评价两者预测临床疗效的可行性。方法：采集44例Ⅱ_B~Ⅳ_A期宫颈鳞癌患者行CCRT治疗前的外周血标本，分别利用流式细胞免疫表型分析和酶联免疫法检测外周血CD4⁺CD25⁺CD127^Low/- Treg计数及血清SCC-Ag水平。收集临床和病理资料，并统计检验2个指标对疗效的预测作用。结果：治疗前外周血CD4⁺CD25⁺CD127^Low/- Treg计数在临床有效组低于无效组［(8.78±2.80)% vs (10.95±2.56)%，P<0.05］，血清SCC-Ag在不同临床疗效组间差异无统计学意义，且这2个、指标之间未发现相关性(Spearman’rho=-0.093，P=0.540)。经受试者工作特征(receiver operating characteristic，ROC)曲线确定治疗前外周血CD4⁺CD25⁺CD127^Low/-Treg及血清SCC-Ag最佳界值分别为9.76%与9.50 ng/mL。单因素分析显示，治疗前外周血CD4⁺CD25⁺CD127^Low/-Treg计数(OR=1.901，95%CI：1.112~3.219，P=0.017)对CCRT疗效有预测作用，而血清SCC-Ag水平无预测作用(OR=0.998，95%CI：0.001~4.253，P=0.897)。多因素Logistic回归分析显示，治疗前外周血CD4⁺CD25⁺CD127^Low/- Treg为独立的临床疗效预测因子(OR=3.115，95%CI：1.253~7.742，P=0.014)。结论：治疗前外周血CD4⁺CD25⁺CD127^Low/-Treg计数用于中晚期宫颈鳞癌患者CCRT临床疗效预测具有可行性。

关键词: 　中晚期宫颈鳞状细胞癌, 同期放化疗, 调节性T细胞, 血清鳞状细胞癌抗原

Abstract: Background and purpose: Due to the lack of cost-effective pre-treatment predictors for advanced cervical squamous cell carcinomas treated with concurrent chemoradiotherapy (CCRT), both baseline circulating CD4⁺CD25⁺CD127^Low/- regulatory T cell (Treg) count and serum squamous cell carcinoma antigen (SCC-Ag) level were measured for this feasibility study. Methods: Peripheral blood samples were collected from 44 patients with stage Ⅱ_B-Ⅳ_A cervical squamous carcinomas before CCRT. Flow cytometry immunophenotyping and enzyme-linked immunosorbent assay were used for circulating CD4⁺CD25⁺CD127^Low/- Treg count and serum SCC-Ag level testing, respectively. Clinical and pathological characteristics were retrospectively reviewed to analyze the predictive value of the 2 indexes. Results: The baseline circulating CD4⁺CD25⁺CD127^Low/-Treg count was lower in the patient group with positive treatment response than in the group with negative response ［(8.78±2.80)% vs (10.95±2.56)%, P<0.05］, and the serum SCC-Ag level showed no significant difference between the 2 groups. No correlation was detected between these 2 markers (Spearman’rho=-0.093, P=0.540). Determined by plotting receiver operating characteristic curves, the best cut-off points were 9.76% for circulating CD4⁺CD25⁺CD127^Low/- Treg count and 9.50 ng/mL for serum SCCAg level, respectively. Univariate analysis showed that pretherapeutic circulating CD4⁺CD25⁺CD127^Low/- Treg count (OR=1.901, 95%CI: 1.112-3.219, P=0.017), but not serum SCC-Ag level (OR=0.998, 95%CI: 0.001-4.253, P=0.897), was predictive of clinical response to CCRT. Multivariate Logistic regression analysis revealed that pre-treatment CD4⁺CD25⁺CD127^Low/- Treg count was an independent predictor for clinical response to CCRT (OR=3.115, 95%CI: 1.253-7.742, P=0.014). Conclusion: Pretherapeutic circulating CD4⁺CD25⁺CD127^Low/- Treg count is a feasible method to predict clinical response to CCRT in patients with advanced cervical squamous cell carcinomas.

Key words: Advanced uterine cervical squamous cell carcinoma, Concurrent chemoradiotherapy, Regulatory T cells, Serum squamous cell carcinoma antigen

郑雨薇,黄啸,郭林,等. 中晚期宫颈鳞癌患者治疗前外周血Treg计数分析[J]. 中国癌症杂志, 2015, 25(4): 241-246.

ZHENG Yuwei, HUANG Xiao, GUO Lin, et al. Pre-treatment circulating regulatory T cell count analysis of advanced cervical squamous cell carcinoma patients[J]. China Oncology, 2015, 25(4): 241-246.

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中晚期宫颈鳞癌患者治疗前外周血Treg计数分析

Pre-treatment circulating regulatory T cell count analysis of advanced cervical squamous cell carcinoma patients

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