Ćelije nalik supresorskim ćelijama mijeloidnog porekla – potencijalni biomarker za prognozu kolorektalnog karcinoma?
Sažetak
Uvod/Cilj. Supresorske ćelije mijeloidnog porekla (SĆMP) predstavljaju heterogenu grupu nezrelih ćelija, koje imaju sposobnost da inhibiraju i urođeni i stečeni imunski odgovor. Zbog svog imunosupresivnog efekta one mogu da podstiču rast i progresiju karcinoma. Kolorektalni karcinom (KRK) je jedan od najčešćih karcinoma u opštoj populaciji za čije odmakle stadijume još uvek ne postoji uspešna terapija. Osim što doprinose razvoju i širenju KRK, SĆMP bi mogle potencijalno biti i markeri njegove prognoze. Cilj rada bio je da se ispita potencijalna prognostička uloga broja SĆMP periferne krvi u KRK. Metode. U prospektivnoj studiji analizirana je mogućnost upotrebe CD16slabo+ granulocita i ćelija nalik monocitnim SĆMP (M-SĆMP), kao i odnosa neutrofila i limfocita (neutrophyl-to-lymphocyte ratio – NLR), limfocita i monocita (lymphocyte-to-monocyte ratio – LMR), odnosa CD16jako+/CD16slabo+ granulocita i odnosa monociti/ćelije nalik M-SĆMP, merenih pre početka tretmana, kao biomarkera za ukupno preživljavanje (UP) kod bolesnika sa KRK. U proceni prognostičke uloge SĆMP u KRK korišćen je parametar odnos rizika, uz odgovarajući interval poverenja od 95%. Rezultati. Analizirano je 47 bolesnika u III i IV stadijumu KRK, prema TNM/AJCC sistemu klasifikacije bolesti. Pouzdani podaci dobijeni su od 32 bolesnika. Uzorci krvi bolesnika bili su uzeti pre eventualnog započinjanja lečenja (operacija, hemioterapija). Pokazano je da su povišene relativne i apsolutne vrednosti CD16slabo+ granulocita kao i apsolutne vrednosti ćelija nalik M-SĆMP bile povezane sa kraćim UP (p < 0,0066, p < 0,0013 i p < 0,0119, redom). Veza između odnosa CD16jako+/CD16slabo+ granulocita kao i odnosa monociti/ćelije nalik M-SĆMP i UP, ukazala je na postojanje pozitivne korelacije između tih parametara, pri čemu je viša vrednost korelacije ukazivala na duže UP bolesnika (p < 0,0054 i p < 0,0148, redom). Između UP i NLR nađena je statistički značajna inverzna korelacija (p = 0,0349). Nije potvrđena statistički značajna povezanost između UP i LMR. Zaključak. Relativne i apsolutne vrednosti CD16slabo+ granulocita, kao i apsolutne vrednosti ćelija nalik M-SĆMP, odnos CD16jako+/CD16slabo+ granulocita, odnos monociti/ćelije nalik M-SĆMP i NLR, mogu biti pouzdani pokazatelji UP kod bolesnika sa KRK.
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