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外周血T淋巴细胞和调节性T细胞与尿道癌患者术后复发转移关系研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:: 54
期数:: 2025年11期

页码:: 1547-1555

栏目:: 临床病理

出版日期:: 2025-11-05

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Title:: Relationship between peripheral blood T lymphocytes and regulatory T cells and postoperative recurrence and metastasis in patients with urethral cancer

作者:: 梁荣兴¹; 王皓¹; 汪鑫¹; 袁庆¹; 童俊超¹; 黄翔²; 李建⁴; （1.武警四川总队医院泌尿外科，四川乐山 614000；2.四川省医学科学院·四川省人民医院泌尿外科，四川成都 610072；3.四川省人民医院金牛医院泌尿外科，四川成都 610007）

Author(s):: LIANG Rongxing¹; WANG Hao¹; WANG Xin¹; YUAN Qing¹; TONG Junchao¹; HUANG Xiang²; LI Jian³; （1.Department of Urology,Sichuan Armed Police Corps Hospital,Leshan 614000,China;2.Department of Urology,Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital,Chengdu 610072,China;3.Department of Urology,Sichuan Provincial People’s Hospital Jinniu Hospital,Chengdu 610007,China）

关键词:: 尿道癌; CD3⁺CD4⁺T淋巴细胞; CD3⁺CD8⁺T淋巴细胞; CD4⁺CD25⁺FoxP3⁺调节性T细胞; 复发转移; 影响因素

Keywords:: Urethral cancer; CD3⁺CD4⁺T lymphocytes; CD3⁺CD8⁺T lymphocytes; CD4⁺CD25⁺FoxP3⁺ regulatory T cells; Recurrence and metastasis; Influencing factors

分类号:: R 737.15

DOI:: DOI:10.3969/j.issn.1000-7377.2025.11.021

文献标志码:: A

摘要:: 目的：探讨外周血T淋巴细胞和调节性T细胞与尿道癌患者术后复发转移的关系。方法：选取接受手术治疗的尿道癌患者30例为研究组，尿道良性肿瘤患者30例为对照组。检测外周血T淋巴细胞及调节性T细胞水平。随访5年，记录患者复发转移情况，并分为复发转移组（13例）和非复发转移组（17例）。从非复发转移组随机选取13例患者，在对照组中随机选取13例患者为良性组。采用免疫荧光染色法检测肿瘤组织中浸润性T淋巴细胞及调节性T细胞的平均荧光强度。绘制Kaplan-Meier曲线分析尿道癌患者外周血T淋巴细胞及调节性T细胞水平与术后复发转移的关系。采用Cox回归分析尿道癌患者术后复发转移的影响因素。结果：研究组患者外周血CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞水平低于对照组，CD4⁺CD25⁺FoxP3⁺调节性T细胞水平高于对照组（均P<0.05）。复发转移组患者外周血CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞水平低于非复发转移组，CD4⁺CD25⁺FoxP3⁺调节性T细胞水平高于非复发转移组（均P<0.05）。与良性组比较，非复发转移组和复发转移组肿瘤组织中CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞平均荧光强度降低，CD4⁺CD25⁺FoxP3⁺调节性T细胞平均荧光强度升高（均P<0.05）。与非复发转移组比较，复发转移组肿瘤组织中CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞平均荧光强度降低，CD4⁺CD25⁺FoxP3⁺调节性T细胞平均荧光强度升高（均P<0.05）。与肿瘤直径≤2 cm、临床分期T₁-T₂和无淋巴结转移患者比较，肿瘤直径＞2 cm、临床分期T₃-T₄、有淋巴结转移患者外周血CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞水平降低，CD4⁺CD25⁺FoxP3⁺调节性T细胞水平升高（均P<0.05）。CD3⁺CD4⁺T淋巴细胞≤20.47%患者5年复发转移率高于CD3⁺CD4⁺T淋巴细胞>20.47%患者（P<0.05）。CD3⁺CD8⁺T淋巴细胞≤18.63%患者5年复发转移率高于CD3⁺CD8⁺T淋巴细胞>18.63%患者（P<0.05）。CD4⁺CD25⁺FoxP3⁺调节性T细胞>11.96%患者5年复发转移率高于CD4⁺CD25⁺FoxP3⁺调节性T细胞≤11.96%患者（P<0.05）。肿瘤直径、临床分期、淋巴结转移、外周血CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞及CD4⁺CD25⁺FoxP3⁺调节性T细胞是尿道癌患者术后复发转移的独立影响因素（均P<0.05）。结论：尿道癌患者外周血CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞水平降低，CD4⁺CD25⁺FoxP3⁺调节性T细胞水平升高，与临床病理特征有关，是患者术后复发转移的影响因素。

Abstract:: Objective:To investigate the relationship between peripheral blood T lymphocytes and regulatory T cells and postoperative recurrence and metastasis in patients with urethral cancer.Methods：A total of 30 patients with urethral cancer who underwent surgical treatment were selected as the study group,and 30 patients with benign urethral tumors were selected as the control group.The levels of peripheral blood T lymphocytes and regulatory T cells were detected.The patients were followed up for 5 years to record the recurrence and metastasis,and they were divided into the recurrence and metastasis group (13 cases) and the non-recurrence and metastasis group (17 cases).Thirteen patients were randomly selected from the non-recurrence and metastasis group,and 13 patients were randomly selected from the control group as the benign group.Immunofluorescence staining was used to detect the mean fluorescence intensity of infiltrating T lymphocytes and regulatory T cells in tumor tissues.Kaplan-Meier curves were drawn to analyze the relationship between the levels of peripheral blood T lymphocytes and regulatory T cells and postoperative recurrence and metastasis in patients with urethral cancer.Cox regression analysis was used to analyze the influencing factors of postoperative recurrence and metastasis in patients with urethral cancer.Results:The levels of peripheral blood CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes in the study group were lower than those in the control group,while the levels of CD4⁺CD25⁺FoxP3⁺regulatory T cells were higher than those in the control group (all P<0.05).The levels of peripheral blood CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes in the recurrence and metastasis group were lower than those in the non-recurrence and metastasis group,while the levels of CD4⁺CD25⁺FoxP3⁺ regulatory T cells were higher than those in the non-recurrence and metastasis group (all P<0.05).Compared with the benign group,the mean fluorescence intensity of CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes in the tumor tissues of the non-recurrence and metastasis group and the recurrence and metastasis group decreased,while the mean fluorescence intensity of CD4⁺CD25⁺FoxP3⁺ regulatory T cells increased (all P<0.05).Compared with the non-recurrence and metastasis group,the mean fluorescence intensity of CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes in the tumor tissues of the recurrence and metastasis group decreased,while the mean fluorescence intensity of CD4⁺CD25⁺FoxP3⁺ regulatory T cells increased (all P<0.05).Compared with patients with tumor diameter≤2 cm,clinical stage T₁-T₂ and no lymph node metastasis,patients with tumor diameter>2 cm,clinical stage T₃-T₄,and lymph node metastasis had lower levels of peripheral blood CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes and higher levels of CD4⁺CD25⁺FoxP3⁺ regulatory T cells (all P<0.05).The 5-year recurrence and metastasis rate of patients with CD3⁺CD4⁺T lymphocytes≤20.47% was higher than that of patients with CD3⁺CD4⁺T lymphocytes>20.47% (P<0.05).The 5-year recurrence and metastasis rate of patients with CD3⁺CD8⁺T lymphocytes≤18.63% was higher than that of patients with CD3⁺CD8⁺T lymphocytes>18.63% (P<0.05).The 5-year recurrence and metastasis rate of patients with CD4⁺CD25⁺FoxP3⁺ regulatory T cells>11.96% was higher than that of patients with CD4⁺CD25⁺FoxP3⁺ regulatory T cells≤11.96% (P<0.05).Tumor diameter,clinical stage,lymph node metastasis,peripheral blood CD3⁺CD4⁺,CD3⁺CD8⁺T lymphocytes and CD4⁺CD25⁺FoxP3⁺ regulatory T cells are independent influencing factors for postoperative recurrence and metastasis in patients with urethral cancer (all P<0.05).Conclusion:The decreased levels of peripheral blood CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes and the increased levels of CD4⁺CD25⁺FoxP3⁺ regulatory T cells in patients with urethral cancer are related to clinical pathological features and are influencing factors for postoperative recurrence and metastasis.

参考文献/References:

[1]金扬旺,刘猛,傅强,等.原发性尿道癌24例诊治分析[J].现代泌尿外科杂志,2023,28(12):1018-1022.
[2]柯涵炜,朱琳,王起,等.探讨原发性尿道癌的临床特点及最佳治疗方法[J].现代泌尿外科杂志,2023,28(12):1013-1017.
[3]CHANG S S.Urologic oncology:Bladder,penis,and urethral cancer,and basic principles of oncology[J].J Urol,2024,211(6):808-809.
[4]HOPKINS B D,QIAN D C,XU K M,et al.Characteristics,treatment,and outcomes of primary urethral cancer:A multicenter review over two decades[J].Clin Genitourin Cancer,2025,23(1):102276.
[5]杨建林.原发性尿道癌的临床特征及治疗方案[J].癌症进展,2020,18(19):1984,2036.
[6]方三高.基于组织学评估和大宗病例分析的原发性女性尿道癌分期修订建议[J].临床与实验病理学杂志,2021,37(8):1008.
[7]LUAN J,LIU Y,CAO M,et al.The pathogenic response of cytotoxic T-lymphocytes,a common therapeutic target for cancer,has a direct impact on treatment outcomes (Review)[J].Oncol Rep,2024,52(1):98.
[8]王潇凡,刘殿娜,林事成,等.冷冻消融联合养肺方治疗对Lewis肺癌CD4⁺CD25⁺Foxp3⁺Treg的影响及机制[J].北京中医药,2023,42(4):408-413.
[9]叶艳艳,陈雪,郭良云,等.原发性尿道癌肉瘤1例[J].中国超声医学杂志,2022,38(4):479.
[10]LEE W,YU J,LEE J L,et al.Clinical features and oncological outcomes of primary female urethral cancer[J].J Surg Oncol,2022,125(5):907-915.
[11]WU Z,CHEN M,MORI R.Urethral carcinoma after skin substitution urethral reconstruction[J].Can J Urol,202431(2):11858-11860.
[12]胡旭昊,孟昆,狄茂军,等.结直肠癌患者手术前后淋巴细胞与单核细胞比值动态变化及其对预后的预测价值[J].陕西医学杂志,2023,52(6):719-722,727.
[13]仝聪,周哲琦,李毅,等.中间入路与侧方入路腹腔镜右半结肠癌根治术疗效对比研究[J].陕西医学杂志,2022,51(9):1110-1113.
[14]FENG E,YANG Y,YANG J,et al.Tumor-infiltrating CD4⁺CD25⁺FOXP3⁺Treg is associated with plasma EBV DNA and disease progression in nasopharyngeal carcinoma[J].Infect Agent Cancer,2025,20(1):29.
[15]KING S N,SRIDHAR C,BERNARD M,et al.PA26 folliculotropic mycosis fungoides with large cell transformation in an adolescent patient[J].Br J Dermatol,2025,193(Suppl_1):ljaf085.385.
[16]GOULIELMAKI M,STOKIDIS S,ANAGNOSTOU T,et al.Frequencies of an immunogenic HER-2/neu epitope of CD8⁺T lymphocytes predict favorable clinical outcomes in prostate cancer[J].Int J Mol Sci,2023,24(6):5954.
[17]TAO Y,XIE Y.Prognostic impact of CD4⁺ and CD8⁺ tumor-infiltrating lymphocytes in patients with colorectal cancer[J].Acta Chir Belg,2023,124(1):35-40.
[18]王岚,唐娟,庾广聿,等.阴道灌洗液中炎症因子与CD4⁺和CD8⁺T细胞在高级别宫颈鳞状上皮内病变与早期宫颈癌发病中的作用研究[J].中国肿瘤临床,2024,51(7):337-341.
[19]CAO S,NGUYEN K,MA K,et al.Multi-omics characterization of perianal fistulizing Crohn’s disease identifies pathogenesis and novel therapeutic targets[J].Inflammatory Bowel Diseases,2025,31(Sup1):S58.
[20]KIM J W,AHN M H,JUNG J Y,et al.Role of chemokines CXCL9,CXCL10,CXCL11,and CXCR3 in the serum and minor salivary gland tissues of patients with Sjgren’s syndrome[J].Clin Exp Med,2024,24(1):133.
[21]刘鹏辉,李娜,董艳,等.肝细胞癌中免疫检查点抑制剂治疗的抵抗机制:现状与挑战[J].中华肝胆外科杂志,2025,31(2):141-146.
[22]孙榕,邵哲,杨宏民,等.吲哚胺2,3-双加氧酶1在神经胶质瘤中的研究进展[J].中华神经外科疾病研究杂志,2025,19(2):115-118.
[23]LEIDNER R S,PAUSTIAN C,JENSEN S M,et al.CT112:An off-the-shelf multivalent vaccine containing cancer’s dark matter,DPV-001,combined with PD-1^+/-GITR in head & neck cancer:Safety,efficacy,and immunodynamics from the phase 1 GITRVax trial[J].Cancer research,2024,84(7_Supplement):CT112.
[24]张国星,李恩泽,温泉,等.益气养荣汤对结直肠癌术后化疗患者骨髓抑制、Treg/Th17细胞、无进展生存期的影响[J].陕西中医,2024,45(4):490-493.
[25]WANG H,WANG T,YAN S,et al.Crosstalk of pyroptosis and cytokine in the tumor microenvironment:From mechanisms to clinical implication[J].Mol Cancer,2024,23(1):268.
[26]黄金石,丁亚亭,曹建中,等.ZBED2通过糖酵解代谢诱导肝细胞癌中PD-L1表达促进免疫逃逸的机制研究[J].中国免疫学杂志,2025,41(2):367-373.
[27]SUN Y,ZHOU L,GU X,et al.Leveraging T cell co-stimulation for enhanced therapeutic efficacy of trispecific antibodies targeting prostate cancer[J].J Immunother Cancer,2025,13(3):e010140.
[28]NARAYAN S,DALAL R,RIZVI Z A,et al.Zinc dampens antitumor immunity by promoting Foxp3⁺ regulatory T cells[J].Front Immunol,2024,15:1389387.
[29]LU Y,ZHANG Y,LI W,et al.Tumor cell-expressed herpesvirus entry mediator regulates proliferation and adaptive immunity in ovarian cancer[J].Immun Inflamm Dis,2025,13(3):e70175.
[30]WU Y Y,CHEN M S,CHEN I,et al.Lidocaine modulates cytokine production and reprograms the tumor immune microenvironment to enhance anti-tumor immune responses in gastric cancer[J].Int J Mol Sci,2025,26(7):3236.
[31]SUN H,CAO Z,ZHAO B,et al.An elevated percentage of CD4⁺CD25⁺CD127^low regulatory T cells in peripheral blood indicates a poorer prognosis in hepatocellular carcinoma after curative hepatectomy[J].BMC Gastroenterol,2025,25(1):340.
[32]刘冬宇,白劼,白红艳.肝细胞癌组织中Foxp3⁺调节性T淋巴细胞表达水平及其与肿瘤免疫相关性研究[J].陕西医学杂志,2021,50(8):1019-1022.
[33]OSAKI M,SAKAGUCHI S.Soluble CTLA-4 regulates immune homeostasis and promotes resolution of inflammation by suppressing type 1 but allowing type 2 immunity[J].Immunity,2025,58(4):889-908.e13.
[34]雷凡,崔昭,秦雅含,等.免疫联合治疗对髓源性抑制细胞作用的研究进展[J].中华微生物学和免疫学杂志,2024,44(11):992-998.
[35]BRENNAN CALLOW B,HE X,MANGUM K,et al.The histone methyltransferase MLL1 regulates Notch signaling and T cell phenotype during pathologic abdominal aortic aneurysm development[J].Circulation,2024,150(Suppl_1):3.
[36]HUANG W,HONG Q,WANG H,et al.MicroRNA-155 inhibition activates Wnt/β-catenin signaling to restore Th17/Treg cell balance and protect against acute ischemic stroke[J].eNeuro,2025,12(2):ENEURO.0347-24.2024.
[37]CHALEPAKI A M,GKORIS M,CHONDROU I,et al.A multi-omics analysis of effector and resting treg cells in pan-cancer[J].Comput Biol Med,2025,189:110021.

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备注/Memo:: 国家卫生健康委员会医疗质量(循证)管理研究项目(YLZLXZ23K014)

更新日期/Last Update: 2025-11-04

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

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