Abstract:

Objective　To analyze the expression of peripheral blood T lymphocyte subsets and interleukin-6 (IL-6) in patients with gastric cancer, and to explore their correlation with prognosis. Methods　A total of 106 patients with gastric cancer treated at Lianyungang Second People's Hospital from June 2021 to June 2023 were selected as an experimental group, and their peripheral blood T lymphocyte subsets (CD3⁺, CD4⁺, and CD8⁺) and IL-6 levels were detected the day after they were admitted to the hospital. Eighty healthy people who came to the hospital for physical examination at the same time were selected as a control group, and their peripheral blood T lymphocyte subsets and IL-6 levels were detected on the day of physical examination. The T lymphocyte subsets and IL-6 levels were compared between the two groups. The patients were followed up 6 months after discharge, and were divided into a poor prognosis group (17 cases) and a good prognosis group (89 cases) according to death and survival. There were 10 males (58.82%) and 7 females (41.18%) in the poor prognosis group; they were (60.47±5.89) years old; 9 cases' (52.94%) education level was middle school or above, and 8 cases' (47.06%) below middle school. In the good prognosis group, there were 55 males (61.80%) and 34 females (38.20%); they were (60.08±5.71) years old; 32 cases' (35.96%) education level was middle school or above, and 57 cases' (64.04%) below middle school. The logistic regression analysis was done for the prognostic factors in the patients. The receiver operating characteristic curves (ROC) were drawn to evaluate the values of peripheral blood T lymphocyte subsets and IL-6 in the prediction of the patients' prognosis. t and χ² were applied. Results　The levels of CD3⁺ and CD4⁺ in the experimental group were lower than those in the control group [(55.27±8.72)% vs. (68.97±6.45)% and (26.42±10.21)% vs. (38.12±5.07)%]; the levels of CD8⁺ and IL-6 in the experimental group were higher than those in the control group [(33.36±6.02)% vs. (24.66±3.75)% and (6.97±3.29) ng/L vs. (3.62±1.01) ng/L]; there were statistical differences (t=-11.821, -9.413, 11.360, and 8.803; all P<0.05). The levels of CD3⁺ and CD4⁺ in the poor prognosis group were lower than those in the good prognosis group [(45.12±10.06)% vs. (57.21±6.97)% and (20.01±10.12)% vs. (27.64±9.81)%]; the levels of CD8⁺ and IL-6 and the proportion of the patients of tumor stage Ⅳ in the poor prognosis group were higher than those in the good prognosis group [(40.12±6.01)% vs. (32.07±5.12)%, (9.75±3.16) ng/L vs. (6.44±3.05) ng/L, and 70.59% (12/17) vs. 32.58% (29/89)]; there were statistical differences (t=-6.068, -2.924, 5.774, and 4.077; χ²=8.692; all P<0.05). The logistic regression analysis showed that tumor stage and CD3⁺, CD8⁺, and IL-6 levels were the factors influencing the patients' prognosis (all P<0.05). The areas under the ROC's of CD3⁺, CD8⁺, and IL-6 for predicting the patients' adverse prognosis were 0.847, 0.853, and 0.768, respectively. Conclusions　In patients with gastric cancer, the levels of CD3⁺ and CD4⁺ are low, and the levels of CD8 ⁺ and IL-6 are high. The levels of CD3⁺, CD8⁺, and IL-6 affect the prognosis of patients with gastric cancer.

Key words:

Gastric cancer, Peripheral blood T lymphocyte subsets, Interleukin-6, Prognosis

摘要：

目的　分析外周血T淋巴细胞亚群及白细胞介素-6（interleukin-6，IL-6）在胃癌患者中的表达，探究其与预后的相关性。方法　选取2021年6月至2023年6月连云港市第二人民医院收治的106例胃癌患者为试验组，入院次日检测其外周血T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺）及IL-6水平。选取同时段于连云港市第二人民医院进行体检的健康者80例为对照组，体检当日检测其外周血T淋巴细胞亚群及IL-6水平。比较两组T淋巴细胞亚群及IL-6水平。胃癌患者院外随访6个月，根据患者死亡、存活情况将其分为预后不良组（17例）、预后良好组（89例）。预后不良组男10例（58.82%），女7例（41.18%），年龄（60.47±5.89）岁；文化程度：中学及以上9例（52.94%），中学以下8例（47.06%）。预后良好组男55例（61.80%），女34例（38.20%），年龄（60.08±5.71）岁；文化程度：中学及以上32例（35.96%），中学以下57例（64.04%）。logistic回归分析影响胃癌患者预后的因素。采用受试者操作特征曲线（ROC）评估外周血T淋巴细胞亚群及IL-6预测胃癌患者预后的价值。采用t检验和χ²检验。结果　试验组CD3⁺、CD4⁺水平低于对照组［（55.27±8.72）%比（68.97±6.45）%、（26.42±10.21）%比（38.12±5.07）%］，CD8⁺、IL-6水平高于对照组［（33.36±6.02）%比（24.66±3.75）%、（6.97±3.29）ng/L比（3.62±1.01）ng/L］，差异均有统计学意义（t=-11.821、-9.413、11.360、8.803，均P<0.05）。预后不良组CD3⁺、CD4⁺水平低于预后良好组［（45.12±10.06）%比（57.21±6.97）%、（20.01±10.12）%比（27.64±9.81）%］，CD8⁺、IL-6水平、肿瘤分期Ⅳ期患者占比高于预后良好组［（40.12±6.01）%比（32.07±5.12）%、（9.75±3.16）ng/L比（6.44±3.05）ng/L、70.59%（12/17）比32.58%（29/89）］，差异有统计学意义（t=-6.068、-2.924、5.774、4.077，χ²=8.692，均P<0.05）。logistic回归分析显示，肿瘤分期、CD3⁺、CD8⁺、IL-6水平是影响胃癌患者预后的因素（均P<0.05）。CD3⁺、CD8⁺、IL-6预测患者预后不良的ROC下面积分别为0.847、0.853、0.768。结论　胃癌患者CD3⁺、CD4⁺低表达，CD8⁺及IL-6高表达。CD3⁺、CD8⁺、IL-6水平是影响胃癌患者预后的因素。

关键词:

胃癌, 外周血T淋巴细胞亚群, 白细胞介素-6, 预后