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老年结肠癌患者的免疫学变化与恢复相关因素:一项初步试验

英文原题:Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial.

PubMed 2025/02/10(内容时间) J Geriatr Oncol Q3 · IF 2.9(JCR 2025)

研究概要

免疫因素,如IL-6水平和NK 细胞数量,在70岁患者中并未减少。此外,该组的术后恢复并未延长。

研究思路结论见上方概要

老年结肠癌患者的免疫与年轻患者不同。具体而言,对术后恢复和免疫的担忧促使了老年结肠癌患者个性化治疗方案的开发。本研究旨在评估70岁及以上与70岁以下患者在免疫因子相关参数及术后恢复方面的差异。

本初步研究纳入了2023年9月至2024年2月在韩国首尔Asan Medical Center接受结肠癌手术切除的75例患者。患者被分为两个年龄组:70岁和<70岁。分析了与恢复相关的临床病理特征,以及恢复、免疫因素和临床特征之间的关联。还比较了两组之间反映患者主观视角的EuroQol-5 Dimensions-3问卷评分。

70岁组有29例患者,<70岁组有46例患者。70岁组在术前(6.71 vs. 4.27,P = 0.04)和术后第21天(POD#21)(13.49 vs. 2.94,P = 0.03)的IL-6水平均显著高于<70岁组。70岁组在所有时间点的平均NK细胞计数均持续较高:术前(24.54 vs. 13.87,P < 0.001)、POD#3(24.32 vs. 15.39,P < 0.001)和POD#21(33.04 vs. 22.47,P < 0.001)。虽然70岁组中术前EQ-5D水平低于平均值的患者比例更高,但这一差异无统计学意义(20.7 % vs. 17.4 %,P = 0.96)。

展开英文摘要原文

INTRODUCTION: Immunity in older patients with colon cancer differs from that in younger patients. Specifically, concerns regarding postoperative recovery and immunity have prompted the development of personalized treatment options for older patients with colon cancer. This study aimed to assess the differences in immunological factor-related parameters and postoperative recovery between patients aged 70 years and < 70 years. MATERIAL AND METHODS: This pilot study included 75 patients who underwent surgical resection for colon cancer between September 2023 and February 2024 at Asan Medical Center, Seoul, Korea. Patients were divided into two age groups: 70 years and < 70 years. The clinicopathological features associated with recovery, and the association among recovery, immunological factors, and clinical characteristics were analyzed. The EuroQol-5 Dimensions-3 questionnaire scores, which reflect the subjective perspectives of patients, were also compared between the two groups. RESULTS: There were 29 patients in the 70 years group and 46 patients in the <70 years group. The 70 years group exhibited significantly higher IL-6 levels than the <70 years group both preoperatively (6.71 vs. 4.27, P = 0.04) and on postoperative day 21 (POD#21) (13.49 vs. 2.94, P = 0.03). The average NK cell counts were consistently higher in the 70 years group across all time points: preoperatively (24.54 vs. 13.87, P < 0.001), POD#3 (24.32 vs. 15.39, P < 0.001), and POD#21 (33.04 vs. 22.47, P < 0.001). While a greater proportion of patients in the 70 years group had below-average preoperative EQ-5D levels, this difference was not statistically significant (20.7 % vs. 17.4 %, P = 0.96). DISCUSSION: Immunological factors, such as IL-6 levels and the number of natural killer cells, did not diminish in patients aged 70 years. Furthermore, postoperative recovery was not prolonged in this group.

论文信息

作者
Lim BL、Kim YI、Lee JL、Kim CW、Yoon YS、Ko Y、Kim KW、Park IJ
第一作者单位
Department of Colon and Rectal Surgery, Seoul Soonchunhyang university hospital, University of Soonchunhyang of Medicine, Seoul, Republic of Korea.South Korea
通讯作者单位
Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: ipark@amc.seoul.kr.South Korea
期刊
Journal of geriatric oncology2025 Apr
原文标识
PubMed 39933336 · DOI 10.1016/j.jgo.2025.102200