外周血免疫细胞亚群及肿瘤标记物对胃大部切除术后患者预后预测的应用价值

目的:探讨外周血免疫细胞亚群及血清肿瘤标记物对胃大部切除术后患者的预后预测的应用价值。方法:应用电化学发光免疫分析法及流式细胞术分别检测25例胃大部切除术后患者的相关血清肿瘤标记物(AFP、CEA、CA19-9、CA12-5、CA72-4)及外周血免疫细胞亚群CD3、NK、CD4、CD8、CD4/CD8,结合长期随访,采用统计学方法分析不同指标之间的相关性及其对胃大部切除术后患者预后预测的应用价值。结果:胃大部切除术后患者外周血免疫细胞亚群及血清肿瘤指标均存在异常,Mann-Whitney检验分析显示外周血CD4 T细胞亚群和CEA呈显著负相关(r=-0.460,P=0.014)。Kaplan-Meier生存分析显示胃大部切除术后患者CD4(P=0.021)和CA72-4(P=0.012)水平和患者预后明显相关。多因素Logistic分析显示CD4(P=0.008)和CA72-4(P=0.010)是影响胃大部切除术后患者预后的独立危险因素。结论:胃大部切除术后患者免疫细胞亚群及血清肿瘤标记物短期内仍存在异常,高水平CD4和低水平CD72-4与患者预后良好显著相关。

The Clinical Value of Peripheral Immune Subpopulation Cells and Tumor Makers in the Prognostic Prediction of Patients after Subtotal Gastrectomy

Objective:To investigate the prognostic value of peripheral immune subpopulation cells and serum tumor makers in subtotal gastrectomy patients.Methods:By measuring the value of serum tumor makers (AFP, CEA, CA19-9, CA12-5, CA72-4) and peripheral immune subpopulation cells (CD3, NK, CD4, CD8, CD4/CD8) in 25 subtotal gastrectomy patients with the method of electrochemiluminescent immunoassay and flow cytometry, we analyzed the correlation between these markers by different statistical methods and their prognostic value for the patients with the data of long-time follow-up, respectively.Results:Both of the peripheral immune subpopulation cells and serum tumor markers are abnormal in patients under subtotal gastrectomy. By Mann-Whitney analysis, we found that the value of peripheral CD4 T cells was negatively associated with CEA (R= -0.460, P=0.014). In addition, the Kaplan-Meier analysis indicated that the value of CD4 T cells (P=0.021) and CA72-4 (P=0.012) was correlated with the overall survival of the patients, and these results were further confirmed by the Logistic analysis, CD4(P=0.008) and CA72-4(P=0.010), which suggested that the value of both are independent risk for the prognosis.Conclusion:Peripheral immune subpopulation cells and serum tumor markers sustained abnormal in a short period for patients after subtotal gastrectomy, high value of CD4 T cells and low value of CA72-4 may be correlated with better prognosis.