Correlation Analysis Of Perioperative Immune Indicators With Clinical Characteristics And Prognosis In Colorectal Cancer Patients

Objective:To analyze the correlation between perioperative peripheral blood lymphocytes and subpopulations and clinicopathological features and short-term prognosis in patients with colorectal cancer(CRC),and to assess the impact of surgery on immune status.Methods:Sixty-eight CRC patients who underwent radical laparoscopic surgery from June 2021 to March 2022 in the Department of Gastrointestinal Colorectal Surgery of the Third Bethune Hospital of Jilin University were selected and their clinical information was collected.T lymphocytes and subpopulations,B lymphocytes and NK cells were analyzed by flow cytometry in venous blood of CRC patients before surgery,on day 1 and day 7 after surgery.ixty-eight CRC patients undergoing radical laparoscopic surgery from June 2021 to March 2022 at the Department of Gastrointestinal Colorectal Surgery,the hospital were selected and their clinical information was collected,and flow cytometry was used to analyze T lymphocytes and subpopulations,B lymphocytes and NK cells in venous blood species of CRC patients before surgery,on day 1 and day 7 after surgery.1.(1)The optimal cut-off values of lymphocyte counts and median values of lymphocyte subpopulations were calculated using ROC curves,and patients were divided into two groups of low and high levels.(2)To analyze the correlation between subgroup indices and clinicopathological characteristics of CRC using univariate analysis,and to assess their impact on short-term prognosis using the Kaplan-Meier method of univariate survival analysis.(3)Apply the positive results in the univariate correlation with short-term prognosis of CRC for COX multifactor regression analysis to identify independent risk factors affecting short-term prognosis.2.Apply the paired-sample t-test method to make a descriptive analysis of the changes in the values of venous blood species lymphocyte subpopulations before surgery and on day 1 and day 7after surgery.Results:1.Preoperative LC levels were correlated with the occurrence of lymph node metastasis,microsatellite status,and survival events;specifically,the higher the LC value,the higher the probability of the presence of lymph node metastasis;the proportion of MSS/MSI-L was higher in the low-value LC group compared with the high-value group;the probability of survival events was significantly lower in the high-value LC study subjects than in the low-value group;CD4~+value levels were correlated with microsatellite status NK cell values were positively correlated with age.NK cell values were positively correlated with age,and the older the age,the higher the level of NK cell values.2.The preoperative LC and CD4~+/CD8~+values were positively correlated with the median time interval between the date of surgery and the occurrence of survival events in CRC patients,with a median time interval of 6.6 months for the preoperative LC low value group and 8.1months for the high value group;the median time interval for the occurrence of survival events was 6.4 months for the CD4~+/CD8~+low value group and 7.4 months for the high value group;the median time interval for the occurrence of survival events was 6.4 months for the preoperative CD4~+/CD8~+low value group and 7.4 months for the high value group.The median time interval for survival events was 6.4 months in the low CD4~+/CD8~+group and 7.4 months in the high CD4~+/CD8~+group;preoperative CD4~+/CD8~+values were independent risk factors affecting the short-term prognosis of CRC,and the risk of short-term survival events in CRC patients in the high CD4~+/CD8~+value group was 64.7%lower than that in the low value group.3.The values of peripheral blood lymphocytes(CD3~+,CD4~+,CD8~+,B cells,NK cells)in CRC patients during the perioperative period showed a precipitous decrease from preoperative to postoperative day 1 and an increasing trend from postoperative day 1 to postoperative day 7.The trend of immune cell values throughout the perioperative period was first decreasing and then increasing,and most of the CD4~+/CD8~+values on postoperative day 7 were higher than those before surgery.Conclusions:1.CRC patients had a significantly higher probability of survival events in the preoperative LC low value group than in the high value group.2.Preoperative LC and CD4~+/CD8~+value levels were positively correlated with short-term prognosis,and CD4~+/CD8~+index was an independent risk factor for short-term prognosis in patients with CRC after surgery.3.Under laparoscopic surgical intervention,the postoperative CD4~+/CD8~+index in CRC patients was higher than the preoperative index after rebound,and there was a certain degree of relief of immunosuppression of the organism by the tumor after resection.