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外周血γδT 细胞对非转移性肾细胞癌根治性切除术后预后的影响:一项回顾性队列研究

英文原题:A retrospective cohort study of the impact of peripheral blood gamma- delta T cells to prognosis of nonmetastatic renal cell cancer after curative resection.

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A retrospective cohort study of the impact of peripheral blood gamma- delta T cells to prognosis of nonmetastatic renal cell cancer after curative resection.

PubMed 2023/10/31(内容时间) Urol Oncol Q2 · IF 2.8(JCR 2025)

研究概要

γδT细胞比例低被确定为RFS的危险因素之一。我们的发现将为制定早期干预策略提供线索,以预防RCC完全切除后的复发,例如在γδT细胞比例低的患者中使用自体γδT细胞的过继性免疫治疗。

研究思路结论见上方概要

γδT细胞具有潜在的抗肿瘤作用,近年来已被应用于过继性免疫治疗。在本研究中,我们关注肾细胞癌(RCC)手术前外周血中γδT细胞的比例,并回顾性探讨其比例是否影响无复发生存期(RFS)和总生存期(OS)。

回顾性分析137例在我院接受手术的局限性非转移性RCC患者。根据外周血γδT细胞比例将患者分为2组:正常γδT细胞组和低γδT细胞组。构建Kaplan-Meier曲线以评估外周血γδT细胞比例与RFS和OS的相关性。构建Cox回归以评估预后风险。进行单因素和多因素logistic回归以评估危险因素与RFS和OS之间的相关性。

在137例患者中,40例外周血γδT细胞比例低于1%,低于正常范围。其余97例外周血中这些细胞比例为1%或更高。在γδT细胞低的组中,13例患者复发,9例患者在观察期间死亡。在γδT细胞正常的组中,16例患者复发,8例患者死亡。γδT细胞正常组在RFS和OS方面表现出显著更好的预后。多因素分析显示,低血红蛋白水平、低γδT细胞比例和高病理T分期(pT)是RFS的统计学独立危险因素。年龄、白蛋白、C反应蛋白(CRP)、% γδT细胞和pT是影响OS的统计学显著因素,而多因素分析中只有pT是独立危险因素。

展开英文摘要原文

AIM: Gamma-delta-T cells (γδT) have potential antitumor roles and have recently been applied in adoptive immunotherapy. In the present study, we focused on the proportion of γδT cells in the peripheral blood just before surgery for renal cell cancer (RCC) and investigated whether their proportion affected recurrence-free survival (RFS) and overall survival (OS) retrospectively. PATIENTS AND METHODS: A total of 137 patients with localized, non-metastatic RCC who received surgery at our institutes were analyzed retrospectively. The patients were divided into 2 groups: normal and low γδT cell groups based on the proportion of peripheral blood γδT cells. Kaplan-Meier curves were constructed to access the association of the proportion of peripheral blood γδT cells to RFS and OS. Cox regression were also constructed to access the risks to prognosis. Uni- and multivariate logistic regressions were performed to access associations between risk factors and, RFS and OS. RESULTS: Among 137 patients, 40 had a proportion of γδT cells in peripheral blood of less than 1%, which was below the normal range. The remaining 97 patients had these cells in peripheral blood at 1% or higher. In the groups with low γδT cells, 13 patients had recurrences, and 9 patients dies during the observation period. In the groups with normal γδT cells, 16 patients had recurrences, and 8 patients died. The normal γδT cell group demonstrated significantly better prognosis in terms of RFS and OS. Multivariate analysis revealed that a low hemoglobin level, a low proportion of γδT cells, and a high pathological T stage (pT) were statistically independent risk factors for RFS. Age, albumin, C-reactive protein (CRP), % γδT cells, and pT were statistically significant factors affecting OS and only pT was an independent risk factor by multivariate analysis. CONCLUSION: A low proportion of γδT cells was identified as one of the risk factors for RFS. Our findings will provide clues to develop strategies for early intervention in preventing recurrence even after complete resection of RCC and, such as adoptive immunotherapy using autologous γδT cells in patients with a low proportion of γδT cells.

论文信息

作者
Kobayashi H、Kondo T、Iizuka J、Yoshida K、Takagi T
单位
Division of Transfusion and Cell-therapy, Tokyo Women's Medical University, Adachi Medical Center, Adachi-ku, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University, Adachi Medical Center, Adachi-ku, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. Electronic address: kobayashi.hirohito@twmu.ac.jp.Japan
期刊
Urologic oncology2023 Dec
原文标识
PubMed 37919100 · DOI 10.1016/j.urolonc.2023.10.001