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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
网络出版:2015-05-25,
纸质出版:2015-05-25
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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.
郑雨薇, 黄啸, 郭林. Pre-treatment circulating regulatory T cell count analysis of advanced cervical squamous cell carcinoma patients[J]. China Oncology, 2015, 25(4): 241-246.
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. DOI: 10.3969/j.issn.1007-3969.2015.04.001.
郑雨薇, 黄啸, 郭林. Pre-treatment circulating regulatory T cell count analysis of advanced cervical squamous cell carcinoma patients[J]. China Oncology, 2015, 25(4): 241-246. DOI: 10.3969/j.issn.1007-3969.2015.04.001.
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)%,P0.05],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。
Background and purpose: Due to the lack of cos
t-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)%
P0.05]
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.
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