免疫球蛋白水平与膀胱肿瘤钬激光切除术后复发的相关性研究
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广西壮族自治区卫生健康委自筹经费科研项目(Z-B20231321);


Correlation between immunoglobulin levels and recurrence after holmium laser resection of bladder tumors
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    摘要:

    目的:探讨免疫球蛋白水平与膀胱肿瘤钬激光切除术后复发的相关性。方法:选取行膀胱肿瘤钬激光切除术治疗的80例膀胱尿路上皮癌患者作为研究对象。根据术后是否复发分为复发组(n=20)及未复发组(n=60)。比较两组患者淋巴细胞亚群、免疫球蛋白及补体水平变化情况;采用Spearman法进行相关性分析;制作受试者工作特征(ROC)曲线,并以曲线下面积(AUC)分析各指标对术后复发的预测价值。结果:术前、术后3、6个月及1年时,复发组自然杀伤细胞(NK)、CD4+ T淋巴细胞占比、CD4+/CD8+比值、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、补体C3及补体C4水平均低于未复发组(P<0.05)。术前及术后1、3个月,复发组CD8+ T淋巴细胞占比高于未复发组(P<0.05)。术前NK、CD4+T淋巴细胞占比、CD4+/CD8+比值、IgA、IgG、IgM、补体C3及补体C4均与术后复发负相关(P<0.05),CD8+T淋巴细胞占比与术后复发正相关(P<0.05)。ROC曲线分析显示,该类指标均对患者术后复发均有较高预测价值,各指标联合预测的AUC为0.890,敏感度为0.800,特异度为0.900(P<0.05)。结论:术前NK、CD4+T淋巴细胞占比、CD4+/CD8+比值、IgA、IgG、IgM、补体C3和补体C4水平偏低及CD8+T淋巴细胞占比水平偏高均提示患者术后复发风险较高,各指标联合检测可用于临床辅助预测患者预后情况。

    Abstract:

    Objective:To investigate the correlation between immunoglobulin levels and recurrence after holmium laser resection of bladder tumors.Methods:80 patients with urothelial carcinoma of the bladder who underwent holmium laser resection of bladder tumors were selected for the study.They were divided into recurrence group(n=20)and non-recurrence group(n=60)according to whether or not it recurred after surgery.The changes in lymphocyte subpopulations,immunoglobulin and complement levels were compared between the two groups,and the correlation analysis was carried out by Spearman's method,and the working curve(ROC)of subjects was made,and the predictive value of each index for postoperative recurrence was analyzed by the area under the curve(AUC).Results:The levels of natural killer cells(NK),CD4+T lymphocyte percentage values,CD4+/CD8+ratio,immunoglobulin A(lgA),immunoglobulin G(lgG),immunoglobulin M(lgM),complement C3,and complement C4 were lower in the relapse group than in the non-relapse group at preoperative,3 months,6 months,and 1 year postoperatively(P<0.05).The CD8+T lymphocyte percentage values were higher in the re-currence group than in the non-recurrence group in the preoperative,1 and 3 months postoperative periods(P<0.05).Preoperative NK,CD4+T-lymphocyte percentage values,CD4+/CD8+ratio,IgA,IgG,IgM,complement C3 and complement C4 were negatively correlated with postoperative recurrence(P<0.05),and CD8+T-lymphocyte percentage values were positively correlated with postoperative recur-rence(P<0.05),which were analyzed by ROC curve analysis to find that all of these indexes had predictive value for postoperative re-lapse of the patients,and the combined prediction of each index had an AUC=0.890,sensitivity of 0.800 and specificity of 0.900(P<0.05).Conclusion:Preoperative low levels of NK,CD4+T-lymphocyte percentage value,CD4+/CD8+ratio,IgA,IgG,IgM,complement C3 and complement C4,and high levels of CD8+T-lymphocyte percentage value suggest that patients are at high risk of postoperative re-currence,and the combination of these indexes can be used to clinically assist in predicting the prognosis of patients.

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陈翔;姚远;龚国通;何天基;于净松;.免疫球蛋白水平与膀胱肿瘤钬激光切除术后复发的相关性研究[J].川北医学院学报,2025,40(2):181-186.

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  • 在线发布日期: 2025-07-24
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