外周血Treg细胞、T淋巴细胞及其亚群与早期宫颈癌的关系及对淋巴结转移的预测价值研究

摘要 目的：分析外周血Treg细胞、T淋巴细胞及其亚群与早期宫颈癌的关系及对淋巴结转移的预测价值。方法：选择我院自2017年1月至2020年12月接诊的60例接受子宫颈癌根治术及盆腔淋巴清扫术的早期宫颈癌患者作为观察组，另选同期的60例健康体检者作为对照组。比较两组外周血Treg细胞、T淋巴细胞及其亚群水平，使用受试者工作特征曲线（ROC）下面积（AUC）评价外周血Treg细胞、T淋巴细胞及其亚群对淋巴结转移的预测效能。结果：观察组外周血Treg细胞、CD8⁺T细胞水平高于对照组，CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值均低于对照组（P＜0.05）；观察组术后外周血Treg细胞、CD8⁺T细胞水平较术前降低，CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值均较术前升高（P＜0.05）；在60例早期宫颈癌患者中，发生淋巴结转移12例；淋巴结转移组术前外周血Treg细胞水平、CD8⁺T细胞高于非淋巴结转移组，CD3⁺T细胞、CD4⁺T细胞、CD4⁺/CD8⁺比值均低于非淋巴结转移组（P＜0.05）；经多因素Logistic回归分析，外周血Treg细胞、CD3⁺T细胞、CD4⁺/CD8⁺比值均是早期宫颈癌患者发生淋巴结转移的独立预测因素（P＜0.05）；经ROC曲线分析，外周血Treg细胞、CD3⁺T细胞联合CD4⁺/CD8⁺比值预测早期宫颈癌患者发生淋巴结转移的AUC为0.910。结论：外周血Treg细胞、T淋巴细胞及其亚群水平与早期宫颈癌的病情演变有关，其中外周血Treg细胞、CD3⁺T细胞联合CD4⁺/CD8⁺比值预测淋巴结转移的效能较好，值得进一步研究应用。

The Relationship between Peripheral Blood Treg Cells, T Lymphocytes and Their Subsets and Early Cervical Cancer and the Predictive Value of Lymph Node Metastasis

ABSTRACT Objective: To analyze the relationship between Treg cells, T lymphocytes and their subsets in peripheral blood and early cervical cancer and the prediction value of postoperative lymph node metastasis. Methods: From January 2017 to December 2020, 60 patients with early cervical cancer who received radical cervical cancer resection and pelvic lymphatic dissection were selected as the observation group, and 60 healthy subjects were selected as the control group. Peripheral blood Treg cells, T lymphocytes and their subsets were compared between the two groups. Area under receiver operating Characteristic Curve(AUC) was used to evaluate the predictive efficacy of peripheral blood Treg cells, T lymphocytes and their subsets on lymph node metastasis. Results: The levels of Treg cells and CD8⁺T cells in peripheral blood of observation group were higher than those of control group, while CD3⁺T cells, CD4⁺T cells and CD4⁺/CD8⁺ ratio were lower than those of control group (P<0.05). The levels of Treg cells and CD8⁺T cells in peripheral blood of the observation group after operation were lower than those before operation, while CD3⁺T cells, CD4⁺T cells and CD4⁺/CD8⁺ ratio were higher than those before operation (P<0.05). Lymph node metastasis occurred in 12 of 60 patients with early cervical cancer. The levels of Treg cells and CD8⁺T cells in peripheral blood of lymph node metastasis group were higher than those of non-lymph node metastasis group,while CD3⁺T cells, CD4⁺T cells and CD4⁺/CD8⁺ ratio were lower than those of non-lymph node metastasis group (P<0.05).Multivariate Logistic regression analysis showed that peripheral blood Treg cells, CD3⁺T cells and CD4⁺/CD8⁺ ratio were independent predictors of lymph node metastasis in patients with early cervical cancer(P<0.05). According to ROC curve analysis, the AUC of peripheral blood Treg cells, CD3⁺T cells combined with CD4⁺/CD8⁺ ratio in predicting lymph node metastasis in patients with early cervical cancer was 0.910. Conclusion: The levels of peripheral blood Treg cells, T lymphocytes and their subsets are related to the disease evolution of early cervical cancer. Among them, peripheral blood Treg cells, CD3⁺T cells combined with CD4⁺/CD8⁺ ratio can predict lymph node metastasis effectively,which is worthy of further study and application.