中国临床研究2024,Vol.37Issue(9) :1369-1373.DOI:10.13429/j.cnki.cjcr.2024.09.012

结直肠癌组织M2型肿瘤相关巨噬细胞预测淋巴结转移的风险

Prediction of lymph node metastasis risk by M2 tumor associated macrophages in colorectal cancer tissue

朱小玄 龙舟 曹少华
中国临床研究2024,Vol.37Issue(9) :1369-1373.DOI:10.13429/j.cnki.cjcr.2024.09.012

结直肠癌组织M2型肿瘤相关巨噬细胞预测淋巴结转移的风险

Prediction of lymph node metastasis risk by M2 tumor associated macrophages in colorectal cancer tissue

朱小玄 1龙舟 1曹少华1
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作者信息

  • 1. 荆门市中心医院荆楚理工学院附属中心医院结直肠肛门外科,湖北荆门 448001
  • 折叠

摘要

目的 基于结直肠癌(CRC)组织M2型肿瘤相关巨噬细胞活性生物标志物可溶性CD163蛋白(sCD163)探讨淋巴结转移(LNM)的风险.方法 回顾性分析2018年1月至2019年5月在荆门市中心医院接受初次手术治疗的152例CRC患者和58例结直肠腺瘤患者的临床资料和术前血清学标志物水平.手术前一天收集血液标本,使用酶联免疫吸附试验(ELISA)测量血清样本中sCD163、癌胚抗原(CEA)、糖类抗原(CA)199水平.术后对患者进行随访,随访截止时间是2024年4月30日.记录患者的总生存期和无病生存期.结果 无LNM患者 sCD163 水平明显低于有 LNM 患者[(2.79±0.76)mg/L vs(4.25±1.50)mg/L,t=7.958,P<0.01].多因素 lo-gistic 回归分析显示,sCD163>3.50 mg/L是CRC患者LNM的独立影响因素(HR=13.973,95%CI:5.385~36.259,P<0.05).sCD163>3.50 mg/L预测CRC患者LNM的效能最高(曲线下面积为0.742,灵敏度为68.8%,特异度为 79.7%).sCD163>3.50 mg/L 组患者中 35 例(46.1%)死亡,sCD163≤3.50 mg/L 患者中 12 例(15.8%)死亡,两组总生存期比较差异有统计学意义(log-rank x2=15.583,P<0.01);sCD163>3.50 mg/L组患者中42例(55.3%)复发,sCD163≤3.50 mg/L患者中25例(32.9%)复发,两组无复发生存期比较差异有统计学意义(log-rank x2=8.368,P=0.004).结论 反映组织中M2巨噬细胞活性的生物标志物sCD163水平升高与CRC患者的LNM和不良预后显著相关,并且sCD163可能是确定LNM高风险CRC患者的潜在预测因子.

Abstract

Objective To investigate the risk of lymph node metastasis(LNM)in colorectal cancer(CRC)based on the M2 macrophage activity biomarker soluble CD 163(sCD163).Methods The clinical data and preoperative blood samples of 152 patients with CRC and 58 patients with colorectal adenoma who received primary surgery in Jingmen Central Hospital from January 2018 to May 2019 were collected.Blood samples were collected the day before surgery,and enzyme-linked immunosorbent assay(ELISA)was used to measure serum levels of sCD163,carcinoembryonic antigen(CEA),and carbohydrate antigen 199(CA199).Postoperative follow-up was conducted with a cutoff date of April 30,2024,and the overall survival and disease-free survival were recorded.Results The level of sCD163 in patients without LNM was significantly lower than in those with LNM[(2.79±0.76)mg/L vs(4.25±1.50)mg/L,t=7.958,P<0.01].Multivariate logistic regression analysis indicated that sCD163>3.50 mg/L was an independent risk factor for LNM in CRC patients(HR=13.973,95%CI:5.385-36.259,P<0.05).sCD163>3.50 mg/L had the highest ability to predict lymph node metastasis in CRC patients(AUC=0.742),with a sensitivity of 68.8%and a specificity of 79.7%.There were 35 patients(46.1%)died in the group of sCD163>3.50 mg/L,and 12 patients(15.8%)died in the group of sCD163≤3.50 mg/L.There was a significant difference in overall survival between the two groups(log-rank x2=15.583,P<0.01).There were 42 patients(55.3%)in the group of sCD163>3.50 mg/L relapsed,and 25 patients(32.9%)in the group of sCD163≤3.50 mg/L relapsed.The difference in recurrence-free survival between the two groups was statistically significant(log-rank x2=8.368,P=0.004).Conclusion Elevated levels of the biomarker sCD163,which reflects M2 macrophage activity in tissues,are significantly associated with LNM and poor prognosis in CRC patients,and sCD163 may be a potential predictive factor for identifying CRC patients at high risk of LNM.

关键词

结直肠癌/淋巴结转移/可溶性CD163蛋白/临床病理/预后/肿瘤相关巨噬细胞

Key words

Colorectal cancer/Lymph node metastasis/Soluble CD163 protein/Clinical pathology/Prognosis/Tumor-associated macrophages

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基金项目

湖北省卫生健康科研基金项目(WJ2019M074)

荆门市科学技术研究与开发计划(2023YDKY030)

出版年

2024
中国临床研究
中华预防医学会

中国临床研究

CSTPCD
影响因子:0.943
ISSN:1674-8182
参考文献量2
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