| 贺家琪,孙学明,黄蓉,卢晓旭,董俊雅,吴慧.NKT细胞和肿瘤异常蛋白在Ⅲ~ⅣB期头颈部鳞癌中的临床价值[J].中华放射医学与防护杂志,2023,43(12):962-968 |
| NKT细胞和肿瘤异常蛋白在Ⅲ~ⅣB期头颈部鳞癌中的临床价值 |
| Clinical value of NKT cells and tumor abnormal proteins in stage Ⅲ-ⅣB head and neck squamous cell carcinoma |
| 投稿时间：2023-06-16 |
| DOI：10.3760/cma.j.cn112271-20230616-00196 |
| 中文关键词: NKT细胞 肿瘤异常蛋白 头颈部鳞癌 放射治疗 预后 |
| 英文关键词:NKT cells Tumor abnormal protein Head and neck squamous cell carcinoma Radiation therapy Prognosis |
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| 中文摘要: |
| 目的 探讨放射治疗前后外周NKT细胞和肿瘤异常蛋白(TAP)的变化在Ⅲ~ⅣB期头颈部鳞癌(HNSCC)中的临床价值。方法 回顾性分析2019年1月至2021年12月河南省肿瘤医院确诊的101例HNSCC病例资料,患者均进行根治性放疗及术后放疗。流式细胞术检测放疗前后外周血NKT细胞所占比例,凝集法测定放疗前后肿瘤异常蛋白(TAP)凝聚面积。分析临床特征和NKT细胞变化、ATP变化等细胞特征与局部复发和远期生存的关系。采用χ2检验或Fisher's 精确概率法进行组间比较,Kaplan-Meier法进行单因素生存预后分析,Cox模型进行多因素预后分析,双变量Pearson线性相关性分析NKT与TAP关系。结果 全组中位随访时间为25个月。1、2、3年局部区域无复发生存(LRRFS)率分别为76.2%、67.3%、64.4%,无远处转移生存(DMFS)率分别为91.1%、90.1%、89.1%,无进展生存(PFS)率分别为69.3%、59.4%、55.4%。组间比较显示,年龄、是否手术、N分期、TNM分期、NKT细胞比例、TAP是3年总生存(OS)率的影响因素;TAP、性别、N分期及TNM分期是3年PFS率的影响因素。多因素分析显示,性别、年龄、N分期、NKT细胞及TAP为HNSCC独立预后因素(HR=3.00、2.35、2.27、2.02、2.56,P<0.05);NKT细胞与TAP相关性分析显示二者呈正相关(r=0.26,P=0.009)。结论 Ⅲ~IVB期HNSCC仅进行根治性手术及术后放疗的复发率较高,外周血中NKT细胞表达及TAP表达水平以及二者在放疗过程中的变化影响局部晚期HNSCC的3年OS、PFS及LRRFS率,值得进一步研究。 |
| 英文摘要: |
| Objective To investigate the clinical value of changes in peripheral NKT cells and tumor abnormal proteins (TAPs) in stage Ⅲ-ⅣB head and neck squamous cell carcinoma (HNSCC) before and after radiotherapy.Methods A retrospective analysis was performed using the data of 101 HNSCC patients, who were confirmed from January 2019 to December 2021 and treated with radical and postoperative radiotherapy. Flow cytometry and the agglutination method were used to determine the proportion of NKT cells in peripheral blood and the TAP coagulation area, respectively before and after radiotherapy. The relationships of clinical features and the cellular features such as changes in NKT cells and ATPs with local recurrence and long-term survival were analyzed. The χ2 test or Fisher's exact test was employed for intergroup comparison. The Kaplan-Meier method and the Cox model were utilized for univariate and multivariate survival prognosis analyses, respectively. The bivariate Pearson linear correlation analysis was conducted to analyze the relationship between NKT and TAP.Results The median follow-up time of the whole group was 25 months. Regarding the 1-, 2-, and 3-year survival rates, the local-regional recurrence-free survival (LRRFS) rates were 76.2%, 67.3%, and 64.4%, respectively, the distant metastasis-free survival (DMFS) rates 91.1%, 90.1%, and 89.1%, respectively, and the progression-free survival (PFS) rates 69.3%, 59.4%, and 55.4%, respectively. The 3-year overall survival (OS) rate was influenced by age, surgery, N stage, TNM stage, NKT cell ratio, and TAP, while the 3-year PFS rate was affected by TAP, sex, N stage, and TNM stage. Multivariate analysis suggests that independent adverse prognostic factors for HNSCC included sex, age, N stage, NKT cells, and TAP (HR=3.00, 2.35, 2.27, 2.02, 2.56, P<0.05). The correlation analysis indicates a positive correlation between NKT cells and TAP (r=0.26, P=0.009).Conclusions Stage Ⅲ-ⅣB HNSCC treated with radical and postoperative radiotherapy is subjected to a high recurrence rate. Further research is required for the expression levels of NKT cells and TAP in peripheral blood, as well as the influence of their changes during radiotherapy on the 3-year OS, PFS, and LRRFS rates of locally advanced HNSCC. |
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