Th17/Treg及IL-6在不同分期胃癌表达水平及其对预后的影响OA

Objective:To investigate the expression levels of Th17/Treg and IL-6 level in gastric cancer(GC)at different stages and their impact on prognosis.Methods:A total of 110 patients with gastric cancer admitted to our hospital from January 2021 to January 2024 were enrolled and divided into Stage Ⅰ(n=42),Stage Ⅱ(n=28),Stage Ⅲ(n=26)and Stage Ⅳ(n=14)according to TNM staging.General clinical da-ta,the levels of Th17,Treg,Th17/Treg ratio and IL-6 were analyzed among all groups.Fasting venous blood(5 mL)was collected on the next day after enrollment,and Th17,Treg were detected by flow cytometry,with IL-6 level measured simultaneously.Pearson correlation analysis was used to evaluate the correlation between indicators and TNM staging.All patients were followed up for 1 year and further divided into a favorable prog-nosis group(n=84)and a poor prognosis group(n=26)based on prognostic outcomes.The levels of Th17,Treg,Th17/Treg ratio and IL-6 level were compared between the two prognostic groups,and receiver operat-ing characteristic(ROC)curve analysis was performed to assess the diagnostic value of these indicators for the prognosis of gastric cancer patients.Results:Compared with Stage Ⅰ,the tumor diameter in Stage Ⅱ was sig-nificantly increased(P<0.05),while no significant differences were observed in differentiation degree,infil-tration depth and lymph node metastasis(P>0.05).Compared with Stage Ⅱ,Stage Ⅲ had significantly lar-ger tumor diameter,higher proportion of poorly differentiated tumors,higher proportion of tumors with infiltra-tion depth below the mucosal layer and higher incidence of lymph node metastasis(P<0.05);no significant differences were observed in the above indicators between Stage Ⅳ and Stage Ⅲ(P>0.05).The levels of Th17,Treg,Th17/Treg ratio and IL-6 level increased significantly with the elevation of TNM staging,with statistically significant differences(P<0.05).TNM stage was positively correlated with the levels of Th17,Treg,Th17/Treg ratio and IL-6 level(r=0.902,0.738,0.813 and 0.654,respectively,all P<0.001).The 1-year survival rates were 92.86%for Stage Ⅰ,82.14%for Stage Ⅱ,65.38%for Stage Ⅲ and 35.71%for Stage Ⅳ patients,and decreased significantly with the progression of TNM stage(P<0.05).The lev-els of Th17,Treg,Th17/Treg ratio and IL-6 level in the poor-prognosis group were significantly higher than those in the favorable-prognosis group(P<0.05).For the prognostic diagnosis of gastric cancer,the area un-der the ROC curves(AUCs)was ranked from high to low:Th17/Treg ratio,Th17,Treg and IL-6 level,and the combined detection of these indicators yielded the highest AUC of 0.921.Conclusion:With the pro-gression of TNM stage,the levels of Th17,Treg,Th17/Treg ratio and IL-6 level significantly increase,which are closely associated with poor prognosis and combined detection of these markers demonstrates high diagnos-tic value for predicting GC prognosis.