吴宏伟 王子安

[摘要] 目的 测定胃癌患者外周血中的总胆固醇（TC）与总淋巴细胞数（LYM），探讨胆固醇、淋巴细胞总数的测定在临床中的意义及两者之间是否有相关性。方法  方便选取2017年 1 月—2019年1 月该院收治的胃癌患者100例作为胃癌组，同期该院体检中心健康体检者50名作为对照组，检测两组研究对象外周血中总胆固醇及总淋巴细胞并进行统计分析，同时将胃癌组中胆固醇、淋巴细胞分别与临床病理特征进行分析并探讨两者之间的相关性。结果  胃癌组外周血中胆固醇水平高于对照组（t=-2.447，P=0.016），淋巴细胞水平低于对照组（t=3.886，P=0.000），差异有统计学意义（P<0.05）;胃癌组中胆固醇、淋巴细胞与性别、浸润程度、分化程度、淋巴結转移、远处转移及TNM分期差异无统计学意义（P>0.05），但随着分化程度及TNM分期情况有明显上升及下降趋势（分化程度：胆固醇： t=0.560，P=0.573;低分化（4.34±1.03）mmol/L;中分化（4.38±0.96）mmol/L;高分化（4.02±0.89）mmol/L;（TNM分期：淋巴细胞：t=0.606，P=0.613;I期（1.78±0.54）×109/L;II期（1.72±0.53）×109/L;III期（1.70±0.61）×109/L;IV期（1.57±0.55）×109/L;胃癌组中胆固醇和淋巴细胞有显著正相关性（r=0.218，P=0.029）。结论 胆固醇及淋巴细胞的异常在胃癌患者中可反应患者的病情情况及营养、免疫状态，通过干预胆固醇的含量可影响机体的免疫状态进而改变其抗肿瘤免疫能力，并为肿瘤的免疫治疗提供新的思路及临床依据。

[关键词] 胃癌;胆固醇;淋巴细胞;肿瘤免疫

[中图分类号] R73          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0175-04

Clinical Significance of Peripheral Blood Cholesterol and Lymphocyte Detection in Patients with Gastric Cancer and Their Correlation

WU Hong-wei， WANG Zi-an

Department of Oncology， the First Affiliated Hospital of Bengbu Medical College， Bengbu， Anhui Province， 233004 China

[Abstract] Objective To determine the total cholesterol （TC） and total lymphocytes （LYM） in the peripheral blood of patients with gastric cancer， and to explore the clinical significance of the determination of cholesterol and total lymphocytes and whether there is a correlation between the two. Methods A total of 100 patients with gastric cancer treated from January 2017 to January 2019 were conveniently selected as the gastric cancer group， and 50 healthy patients from the physical examination center of the hospital were used as the control group. Total cholesterol and total lymphocytes in the peripheral blood of the two subjects were measured and analyzed. At the same time， the cholesterol and lymphocytes in the gastric cancer group were analyzed with clinicopathological characteristics and the correlation between the two was explored. Results The levels of cholesterol in the peripheral blood of gastric cancer group were higher than those in the control group （t=-2.447， P=0.016）， and the levels of lymphocytes were lower than those in the control group （t=3.886， P=0.000）. The differences were statistically significant（P<0.05）. Cholesterol， lymphocytes and gender， degree of infiltration， degree of differentiation， lymph node metastasis， distant metastasis， and TNM staging were not statistically significant and had no significant correlation （P>0.05）， but with the degree of differentiation and TNM staging significant upward and downward trends （differentiation degree： cholesterol： t=0.560，P=0.573;poorly differentiated （4.34±1.03）mmol/L; moderately differentiated （4.38 ± 0.96）mmol/L; highly differentiated （4.02±0.89）mmol/L; （TNM stage： lymphocytes： t=0.606， P=0.613; Stage I （1.78 ± 0.54）×109/L; Stage II （1.72 ± 0.53）×109/L; Stage III （1.70±0.61）×109/L; Stage IV （1.57 ± 0.55）×109/L; There was a significant positive correlation between cholesterol and lymphocytes in the gastric cancer group （r=0.218， P=0.029）. Conclusion Cholesterol and lymphocyte abnormalities can reflect the patient's condition and nutrition and immune status in patients with gastric cancer. Intervention of cholesterol content can affect the body's immune status and thus change its anti-tumor immune ability， and provide new opportunities and clinical basis for tumor immunotherapy. [Key words] Gastric cancer; Cholesterol; Lymphocyte; Tumor immunity

胆固醇与多种肿瘤存在相关性，但与胃癌的关联性至今并未达到一致，近年，基于T淋巴细胞的肿瘤免疫治疗取得新进展，研究发现胆固醇水平可影响CD8+T细胞的免疫功能[1]，而外周血中胆固醇与淋巴细胞的相关性未得到验证;淋巴细胞作为能反应机体免……