宫颈癌患者趋化因子配体22和调节性T细胞水平与术后肿瘤复发的相关性分析OA

Objective To investigate the correlation between the levels of chemokine ligand 22(CCL22)and regulatory T cells(Treg)and postoperative tumor recurrence in cervical cancer patients.Methods Clinical data of 113 cervical cancer patients who underwent surgical treatment at the People's Hospital of Xinjiang Uygur Autonomous Region from August 2019 to December 2022 were retrospectively collected.Based on recurrence status during the 2year postoperative followup,patients were divided into a recurrence group(21 cases)and a nonrecurrence group(92 cases).Preoperative levels of CCL22 and Treg were collected to explore their correlation with postoperative recurrence in cervical cancer patients.Results Among the 113 cervical cancer patients,21(18.58%)experienced recurrence within 2 years after surgery.The tumor diameter in the recurrence group was significantly larger than that in the nonrecurrence group,and the proportions of International Federation of Gynecology and Obstetrics stage ⅡA and poor differentiation were significantly higher in the recurrence group,with statistically significant differences(P<0.05).The preoperative levels of CCL22 and Treg in the recurrence group were significantly higher than those in the nonrecurrence group,with a statistically significant difference(P<0.05).Receiver operating characteristic curve analysis showed that the areas under the curve for predicting postoperative recurrence using preoperative CCL22 level alone,Treg level alone,and their combination were 0.831,0.765,and 0.904,respectively.Logistic multivariate regression analysis indicated that high preoperative levels of CCL22(OR=31.493,95%CI:3.692-268.611)and Treg(OR=5.089,95%CI:1.036-24.995)were independent risk factors for postoperative recurrence in cervical cancer patients(both P<0.05).After adjusting for confounding factors,a positive interaction was observed between preoperative CCL22 and Treg levels regarding postoperative recurrence,with an interaction index of 11.706,indicating that the synergistic effect of the two was 11.706 times the sum of their individual effects.The super hazard ratio was 43.337,indicating that when other factors were controlled,the recurrence risk increased by an additional 43.337 fold when both factors were present simultaneously compared to when each existed independently.The attributable proportion was 89.57%,suggesting that 89.57%of the recurrence risk in patients with high levels of both factors could be attributed to their interaction.Decision curve analysis showed that the decision curve plotted using preoperative CCL22 combined with Treg had a high net benefit rate.When the threshold ranged from 0 to 1.00,the net benefit rate was greater than 0,with a maximum net benefit rate of 0.185.Conclusion High preoperative levels of CCL22 and Treg are independent risk factors for postoperative recurrence in cervical cancer patients.The combination of CCL22 and Treg shows high diagnostic efficacy in predicting postoperative recurrence risk.