Prognostic predictive value of peripheral blood T lymphocyte levels and pathological parameters in patients with epithelial ovarian cancer

doi:10.11958/20250354

Abstract

Abstract:

Objective To investigate the changes in peripheral blood T-lymphocyte levels in patients with epithelial ovarian cancer (OC), and to analyze their relationship with patients' pathological parameters and their predictive value for patients' prognosis. Methods A total of 60 epithelial OC patients were selected as the case group, and 85 benign ovarian tumor patients were selected as the benign group. All patients in the case group received laparoscopic surgery and were followed up for 3 years. According to the prognosis, patients were divided into the good prognosis group (n=32) and the poor prognosis group (n=28). The peripheral blood levels of CD3⁺, CD4⁺ and CD8⁺ were detected, and the ratio of CD4⁺/CD8⁺ was calculated. The peripheral blood levels of T lymphocytes in epithelial OC patients with different clinicopathological characteristics were compared. Receiver operating characteristic curve (ROC) was drawn to analyze the prognostic value of peripheral blood T lymphocytes in patients with epithelial OC. Results Compared with the benign group, the peripheral blood levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were decreased in the case group, and the CD8⁺ level was increased (P<0.05). Compared with epithelial OC patients with stage Ⅰ-Ⅱ, high differentiation, no peritoneal effusion and no lymph node metastasis, the peripheral blood CD3⁺ and CD4⁺ levels in epithelial OC patients with stage Ⅲ-Ⅳ, moderate and low differentiation, with peritoneal effusion and lymph node metastasis were lower, while CD8⁺ was higher (P<0.05). Compared with the good prognosis group, the peripheral blood levels of CD3⁺ and CD4⁺ were lower in the poor prognosis group, while the CD8⁺level was higher (P<0.05). ROC analysis showed that the area under the curve (AUC) of combined detection of CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ to predict the prognosis of epithelial OC patients was 0.952, which was higher than that of single detection of CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ (P<0.05). Conclusion Peripheral blood T-lymphocyte levels are correlated with clinicopathological characteristics and prognosis of patients with epithelial OC, and the combined testing of each index is more advantageous in predicting the prognosis of patients with epithelial OC.

Key words: ovarian neoplasms, T-lymphocytes, prognosis, pathological characteristics, predictive value

CLC Number:

R737.31

Figures/Tables 6

References 18

[1]	PENG L, LAI Y, CAO B. Advances in small extracellular vesicles:roles in the tumor microenvironment and epithelial ovarian cancer diagnosis and treatment[J]. Front Oncol, 2025, 15:1526944. doi:10.3389/fonc.2025.1526944.
[2]	喻萍, 周敏, 苏丹. 卵巢癌化疗耐药预测模型的建立及效果评价[J]. 天津医药, 2024, 52(11):1177-1183.
	YU P, ZHOU M, SU D. Construction and validation of chemotherapy resistance prediction model for ovarian cancer[J]. Tianjin Med J, 2024, 52(11):1177-1183. doi:10.11958/20240546.
[3]	王学芹, 满霞霞, 刘东珍, 等. 晚期上皮性卵巢癌患者5年生存率的影响因素[J]. 中国妇幼保健, 2020, 35(24):4837-4839.
	WANG X Q, MAN X X, LIU D Z, et al. Factors influencing the 5-year survival rate of patients with advanced epithelial ovarian cancer[J]. Maternal & Child Health Care of China, 2020, 35(24):4837-4839. doi:10.19829/j.zgfybj.issn.1001-4411.2020.24.062.
[4]	HORNBURG M, DESBOIS M, LU S, et al. Single-cell dissection of cellular components and interactions shaping the tumor immune phenotypes in ovarian cancer[J]. Cancer Cell, 2021, 39(7):928-944.e6. doi:10.1016/j.ccell.2021.04.004.
[5]	ÖLMEZ F, OĞLAK S C, ÖLMEZ Ö F, et al. High expression of CD8 in the tumor microenvironment is associated with PD-1 expression and patient survival in high-grade serous ovarian cancer[J]. Turk J Obstet Gynecol, 2022, 19(3):246-256. doi:10.4274/tjod.galenos.
[6]	中国抗癌协会妇科肿瘤专业委员会. 卵巢恶性肿瘤诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(7):739-749.
	Gynecologic Tumor Committee of Chinese Anti-cancer Association. Guidelines for diagnosis and treatment of ovarian malignant tumors(fourth edition)[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(7):739-749. doi:10.19538/j.fk2018070110.
[7]	谢幸, 孔北华, 段涛. 妇产科学[M]. 9版. 北京: 人民卫生出版社, 2018:33-41.
	XIE X, KONG B H, DUAN T. Obstetrics and gynecology[M]. 9th ed. Beijing: People's Health Publishing House, 2018:33-41.
[8]	喻朝霞, 潘陶强, 张云荣, 等. 上皮性卵巢癌组织中TGF-β1和MDR1表达与患者临床病理特征的关系[J]. 贵州医科大学学报, 2021, 46(1):120-124.
	YU Z X, PAN T Q, ZHANG Y R, et al. The association of the expression levels of TGF-β1 and MDR1 with clinicopathological characteristics in patients with epithelial ovarian cancer[J]. Journal of Guizhou Medical University, 2021, 46(1):120-124. doi:10.19367/j.cnki.2096-8388.2021.01.022.
[9]	WAN C, KEANY M P, DONG H, et al. Enhanced efficacy of simultaneous pd-1 and pd-l1 immune checkpoint blockade in high-grade serous ovarian cancer[J]. Cancer Res, 2021, 81(1):158-173. doi:10.1158/0008-5472.
[10]	UKITA M, HAMANISHI J, YOSHITOMI H, et al. CXCL13-producing CD4⁺ T cells accumulate in the early phase of tertiary lymphoid structures in ovarian cancer[J]. JCI Insight, 2022, 7(12):e157215. doi:10.1172/jci.insight.157215.
[11]	潘英连, 范雅丹, 古淑贞, 等. 卵巢癌肿瘤免疫微环境特征鉴定及预后预测模型构建[J]. 中国实用妇科与产科杂志, 2023, 39(6):647-651.
	PAN Y L, FAN Y D, GU S Z, et al. Identification of tumor immune microenvironment characteristics and construction of prognosis prediction in ovarian cancer[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2023, 39(6):647-651. doi:10.19538/j.fk2023060116.
[12]	娄俊, 易韵, 储小燕, 等. 70例卵巢癌患者治疗期间外周血T淋巴细胞亚群测定的临床意义[J]. 实用癌症杂志, 2022, 37(5):780-782.
	LOU J, YI Y, CHU X Y, et al. Clinical Significance of peripheral blood T lymphocyte subsets measured during treatment in 70 ovarian cancer patients[J]. The Practical Journal of Cancer, 2022, 37(5):780-782. doi:10.3969/j.issn.1001-5930.2022.05.021.
[13]	莫婧, 谭广萍, 韦露薇, 等. CD4⁺T细胞亚群Th1/Th2和Th17/Treg在卵巢癌中的分布及意义[J]. 中国老年学杂志, 2018, 38(23):5703-5705.
	MO J, TAN G P, WEI L W, et al. Distribution and significance of CD4⁺ T cell subsets Th1/Th2 and Th17/Treg in ovarian cancer[J]. Chinese Journal of Gerontology, 2018, 38(23):5703-5705.
[14]	朱莉, 邓飞, 秦惠萍, 等. 卵巢癌患者血清人附睾蛋白4、抗缪勒管激素水平与T淋巴细胞水平的相关性研究[J]. 癌症进展, 2019, 17(18):2201-2203.
	ZHU L, DENG F, QIN H P, et al. Correlation between serum human epididymis protein 4, anti-Müllerian hormone levels and T lymphocyte levels in patients with ovarian cancer[J]. Cancer Progress, 2019, 17(18):2201-2203. doi:10.11877/j.issn.1672-1535.2019.17.18.25.
[15]	ARMAN KARAKAYA Y, ATıGAN A, GÜLER Ö T, et al. The relation of CD3,CD4,CD8 and PD-1 expression with tumor type and prognosis in epithelial ovarian cancers[J]. Ginekol Pol, 2021, 92(5):344-351. doi:10.5603/GP.a2021.0080.
[16]	曾海荣, 黄丹, 张建军, 等. 外周血NK细胞、CD8⁺T淋巴细胞水平预测早期卵巢癌患者腹腔镜术后淋巴结转移分析[J]. 国际检验医学杂志, 2022, 43(14):1684-1688.
	ZENG H R, HUANG D, ZHANG J J, et al. An analysis on NK cells and CD8⁺T lymphocytes levels in peripheral blood for the prediction of lymph node metastasis in patients with early ovarian cancer after laparoscopic surgery[J]. International Journal of Laboratory Medicine, 2022, 43(14):1684-1688. doi:10.3969/j.issn.1673-4130.2022.14.005.
[17]	付海霞, 杜欣宇, 宋亚男. 上皮性卵巢癌患者血清可溶性白细胞介素-2受体、人附睾蛋白4、T淋巴细胞亚群水平及临床意义[J]. 癌症进展, 2021, 19(7):729-732.
	FU H X, DU X Y, SONG Y N. Serum levels of soluble interleukin-2 receptor,human epididymal protein 4 and T lymphocyte subsets in patients with epithelial ovarian cancer and their clinical significance[J]. Cancer Progress, 2021, 19(7):729-732. doi:10.11877/j.issn.1672-1535.2021.19.07.20.
[18]	YE S, CHEN W, ZHENG Y, et al. Peripheral lymphocyte populations in ovarian cancer patients and correlations with clinicopathological features[J]. J Ovarian Res, 2022, 15(1):43-43. doi:10.1186/s13048-022-00977-3.

组别	n	年龄/岁	BMI/（kg/m²）	妊娠史	妊娠次数/次
良性组	85	40.22±5.91	23.23±1.09	81（95.29）	2.72±0.65
病例组	60	40.20±6.01	23.18±1.12	57（95.00）	2.67±0.66
t或χ²		0.023	0.277	0.007	0.465

组别	n	年龄/岁	BMI/（kg/m²）	妊娠史	妊娠次数/次
良性组	85	40.22±5.91	23.23±1.09	81（95.29）	2.72±0.65
病例组	60	40.20±6.01	23.18±1.12	57（95.00）	2.67±0.66
t或χ²		0.023	0.277	0.007	0.465

组别	n	CD3⁺/%	CD4⁺/%	CD8⁺/%	CD4⁺/CD8⁺
良性组	85	62.38±3.39	39.25±2.67	21.22±1.34	1.86±0.17
病例组	60	53.12±1.56	26.58±1.72	27.12±3.10	0.99±0.14
t		19.729^＊＊	32.329^＊＊	15.581^＊＊	32.423^＊＊

组别	n	CD3⁺/%	CD4⁺/%	CD8⁺/%	CD4⁺/CD8⁺
良性组	85	62.38±3.39	39.25±2.67	21.22±1.34	1.86±0.17
病例组	60	53.12±1.56	26.58±1.72	27.12±3.10	0.99±0.14
t		19.729^＊＊	32.329^＊＊	15.581^＊＊	32.423^＊＊

病理特征	n	CD3⁺/%	t	CD4⁺/%	t	CD8⁺/%	t	CD4⁺/CD8⁺	t
肿瘤分期
Ⅰ—Ⅱ期	25	54.13±1.61	5.007^＊＊	28.18±1.05	9.909^＊＊	24.53±2.74	7.670^＊＊	1.01±0.17	1.014
Ⅲ—Ⅳ期	35	52.41±1.05	5.007^＊＊	25.44±1.06	9.909^＊＊	28.96±1.73	7.670^＊＊	0.98±0.12	1.014
分化程度
中低分化	28	52.54±1.13	2.879^＊＊	25.82±0.98	3.491^＊＊	28.63±1.84	3.927^＊＊	0.96±0.11	1.510
高分化	32	53.63±1.71	2.879^＊＊	27.25±1.95	3.491^＊＊	25.80±3.40	3.927^＊＊	1.02±0.16	1.510
腹腔积液
有	34	52.66±1.38	2.796^＊＊	26.05±1.31	2.933^＊＊	28.15±2.42	3.166^＊＊	1.00±0.12	0.072
无	26	53.73±1.59	2.796^＊＊	27.28±1.95	2.933^＊＊	25.77±3.41	3.166^＊＊	0.99±0.17	0.072
淋巴结转移
有	35	52.53±1.21	3.881^＊＊	25.88±1.51	4.290^＊＊	28.69±2.34	5.897^＊＊	0.99±0.12	0.316
无	25	53.95±1.63	3.881^＊＊	27.57±1.50	4.290^＊＊	24.91±2.69	5.897^＊＊	1.00±0.17	0.316