2025 年第 10 期 第 20 卷

淋巴细胞亚群及细胞因子对晚期结直肠癌免疫治疗效果的预测价值研究

Study on the predictive value of lymphocyte subsets and cytokines for the effect of immunotherapy in advanced colorectal cancer

作者：陈燕吴雨霏国风

英文作者：Chen Yan Wu Yufei Guo Feng

单位：南京医科大学附属苏州医院江苏省苏州市立医院肿瘤内科，苏州215000

英文单位：Department of Oncology the Affiliated Suzhou Hospital of Nanjing Medical University Suzhou Municipal Hospital Jiangsu Province Suzhou 215000 China

关键词：晚期结直肠癌；淋巴细胞亚群；细胞因子；免疫治疗；预测价值

英文关键词：Advancedcolorectalcancer;Lymphocytesubsets;Cytokines;Immunotherapy;Predictivevalue

• 摘要：

• 目的 评估淋巴细胞亚群及细胞因子在预测晚期结直肠癌患者免疫治疗效果中的作用，以期为晚期结直肠癌患者的个体化治疗提供有效的临床预测工具。方法 收集江苏省苏州市立医院2022年10月至2025年4月收治的接受程序性细胞死亡受体1/程序性细胞死亡受体配体1抑制剂治疗的52例晚期结直肠癌患者的临床资料进行回顾性分析。根据实体瘤疗效评价标准分为完全缓解、部分缓解、疾病稳定和疾病进展，其中完全缓解、部分缓解、疾病稳定患者归入控制组（29例），疾病进展患者归入进展组（23例）。比较2组治疗前后淋巴细胞亚群（调节性T细胞、CD+3、CD+4、CD+8、CD+19、自然杀伤细胞）和细胞因子［白细胞介素2（IL-2）、IL-4、IL-6、IL-10、肿瘤坏死因子α、γ干扰素］的水平，分析其与免疫治疗效果的相关性。结果 治疗前控制组自然杀伤细胞水平显著高于进展组［19.1%（14.6%,24.9%）比8.0%（7.2%,18.2%）］（P=0.041）。治疗后进展组IL-6显著高于治疗前，控制组显著低于治疗前，控制组低于进展组［4.7（3.5,9.5）ng/L比17.3（14.7,47.4）ng/L］，差异有统计学意义（均P<0.05）。通过Pearson相关性分析发现，IL-6与肿瘤进展呈负相关关系（r=-0.489, P=0.003），提示IL-6水平越高，治疗效果越差。结论 自然杀伤细胞和IL-6在预测晚期结直肠癌患者免疫治疗效果中具有潜在价值。自然杀伤细胞水平的升高与更好的治疗反应相关，而IL-6的升高则可能预示较差的预后。

• Objective To evaluate the role of lymphocyte subsets and cytokines in predicting the efficacy of immunotherapy in patients with advanced colorectal cancer, in order to provide effective clinical predictive tools for individualized treatment of patients with advanced colorectal cancer. Methods The clinical data of 52 patients with advanced colorectal cancer treated with programmed cell death receptor-1/programmed cell death receptor ligand-1 inhibitor in Suzhou Municipal Hospital, Jiangsu Province from October 2022 to April 2025 were collected and retrospectively analyzed. According to the response evaluation criteria in solid tumors, the patients were divided into complete response, partial response, stable disease and progressive disease. The patients with complete response, partial response and stable disease were classified into the control group (29 cases), and the patients with progressive disease were classified into the progression group (23 cases). The levels of lymphocyte subsets (regulatory T cells, CD+3, CD+4, CD+8, CD+19, natural killer cells) and cytokines ［interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α, interferon-γ］ were compared between the two groups before and after treatment, and their correlation with the efficacy of immunotherapy was analyzed. Results The level of natural killer cells in the control group was significantly higher than that in the progression group before treatment ［19.1%（14.6%,24.9%） vs 8.0%（7.2%,18.2%）］(P=0.041). After treatment, IL-6 in the progression group was significantly higher than that before treatment, and IL-6 in the control group was significantly lower than that before treatment, and IL-6 in the control group was lower than that in the progression group ［4.7（3.5,9.5）ng/L vs 17.3（14.7,47.4）ng/L］(all P<0.05). Through Pearson correlation analysis, it was found that IL-6 was negatively correlated with tumor progression (r=-0.489, P=0.003), suggesting that the higher the IL-6 level, the worse the treatment effect. Conclusion Natural killer cells and IL-6 have potential value in predicting the response of immunotherapy in patients with advanced colorectal cancer. Increased levels of natural killer cells are associated with better treatment response, whereas increased IL-6 may predict a worse prognosis.