Stathmin联合免疫指标对食管癌同步放化疗患者疗效及预后的预测价值OA
Predictive Value of Stathmin Combined with Immune Indicators for Efficacy and Prognosis of Synchronous Chemoradiotherapy in Patients with Esophageal Cancer
目的 评估Stathmin及T淋巴细胞亚群对食管癌同步放化疗患者疗效及预后的预测效能.方法 选取2022 年 1 月至2023 年 12 月濮阳油田总医院收治的 110 例行同步放化疗的局部晚期食管癌患者,按疗效将患者分为无效组 23 例及有效组 87 例,检测患者治疗前后血清Stathmin及T淋巴细胞亚群变化.所有患者治疗后随访12 个月,将患者分为预后不良组 29 例及预后良好组 81 例,进一步分析相关指标与患者预后的关系,同时采用受试者工作特征曲线(ROC)分析不同指标对预后的预测效能.结果 治疗有效组中预后不良率为 17.24%(15/87),显著低于无效组的 60.87%(14/23)(χ2=17.840,P＜0.001);治疗后有效组血清Stathmin水平显著低于无效组(P＜0.001);CD4+上升和CD8+下降程度更为明显(P＜0.001).与预后不良组相比,预后良好组患者Stathmin丰度及CD4+/CD8+显著下降(P＜0.001),而CD4+及CD8+显著升高(P＜0.001).多因素Logistic 回归分析显示,Stathmin及CD4+/CD8+比值升高为独立危险因素;CD4+及CD8+比例升高为保护因素.ROC分析发现,Stathmin与CD4+/CD8+联合用于预后预测时的AUC高于单独指标.当血清Stathmin丰度＞4.50 μg·L-1 或CD4+/CD8+＞1.18 时,患者预后不良风险增加.生存分析显示,Stathmin高表达组与CD4+/CD8+高比值组的无进展生存期(PFS)显著缩短(P=0.017).结论 血清Stathmin联合CD4+/CD8+比值对食管癌同步放化疗患者预后具有较高的预测效能,其高表达或高比值与更短的PFS相关.
Objective To evaluate the predictive efficacy of Stathmin and T-lymphocyte subsets for therapeutic outcomes and prognosis in esophageal cancer patients undergoing concurrent chemoradiotherapy.Methods 110 patients with locally advanced esophageal cancer receiving concurrent chemoradiotherapy at Puyang oilfield general hospital from January 2022 to December 2023 were enrolled and divide into an ineffective group of 23 cases and an effective group of 87 cases according to the efficacy.Serum Stathmin levels and T-lymphocyte subsetswere measured before and after treatment.After a 12-month follow-up,patients were stratified into a poor prognosis group(n=29)and a good prognosis group(n=81).Associations between these markers and prognosis were analyzed.Receiver operating characteristic(ROC)curves were used to analyze the predictive power of different indicators on prognosis.Results The incidence of poor prognosis in the effective group(17.24%,15/87)was significantly lower than that in the ineffective group(60.87%,14/23)(χ2=17.840,P＜0.001).Post-treatment serum Stathmin level in the effective group was significantly lower than that in the ineffective group(P＜0.001),with more pronounced increases in CD4+and decreases in CD8+(P＜0.001).Compared to the poor prognosis group,the good prognosis group showed significantly lower Stathmin levels and CD4+/CD8+ratios(P＜0.001),but higher CD4+and CD8+proportions(P＜0.001).Multivariate logistic regression identified elevated Stathmin(OR=2.983,P＜0.001)and CD4+/CD8+ratio(OR=1.338,P＜0.001)as independent risk factors,while increased CD4+and CD8+were protective factors.ROC analysis revealed higher predictive efficacy for the combination of Stathmin and CD4+/CD8+than either marker alone.Patients with serum Stathmin＞4.50 μg·L-1 or CD4+/CD8+＞1.18 had increased risk of poor prognosis.Survival analysis showed that patients with high Stathmin expression or a high CD4+/CD8+ratio had significantly shorter progression-free survival(P＜0.001,P=0.017,respectively).Conclusion Combined assessment of serum Stathmin and CD4+/CD8+ratio provides high predictive efficacy for prognosis in esophageal cancer patients treated with concurrent chemoradiotherapy with high levels associatedwith inferior PFS.
于明军
濮阳油田总医院,河南 濮阳,457001
医药卫生
食管癌同步放化疗疗效预后stathminCD4+/CD8+
esophageal cancerconcurrent chemoradiotherapycurative effectprognosisStathminCD4+/CD8+
《食管疾病》 2026 (1)
22-27,38,7
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