Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2024; 16(2): 463-470
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.463
Immune function status of postoperative patients with colon cancer for predicting liver metastasis
Le Xiong, Fang-Chen Liu
Le Xiong, Department of Clinical Laboratory, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China
Fang-Chen Liu, Department of Blood Transfusion, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei Province, China
Author contributions: Xiong L and Liu FC contributed equally to this work; Xiong L and Liu FC designed the study; Xiong L contributed to the analysis of the manuscript; Xiong L and Liu FC involved in the data and writing of this article; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the [Xiangyang No. 1 People’s Hospital, Hubei University of Medicine] Institutional Review Board (No. XYYYE20230123).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang-Chen Liu, Doctor, Master's Student, Department of Blood Transfusion, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, No. 30 Shengli Street, Xiangyang 441000, Hubei Province, China. hhdylyh@163.com
Received: December 12, 2023
Peer-review started: December 12, 2023
First decision: January 2, 2024
Revised: January 4, 2024
Accepted: January 30, 2024
Article in press: January 30, 2024
Published online: February 27, 2024
Processing time: 75 Days and 6.4 Hours
Abstract
BACKGROUND

Colon cancer (CC) has a high incidence rate. Radical resection is the main treatment method for CC; however, liver metastasis (LM) often occurs post-surgery. The liver contains both innate and adaptive immune cells that monitor and remove abnormal cells and pathogens. Before LM, tumor cells secrete cytokines and exosomes to adjust the immune microenvironment of the liver, thus forming an inhibitory immune microenvironment for colonization by circulating tumor cells. This indicates that the immune state of patients with CC plays a crucial role in the occurrence and progression of LM.

AIM

To observe and analyze the relationship between immune status and expression of tumor factors in patients with LM of CC, and to provide a scientific intervention method for promoting the patient prognosis.

METHODS

A retrospective analysis was performed. The baseline data of 100 patients with CC and 100 patients with CC who suffered from postoperative LM and were admitted to our hospital from May 2021 to May 2023 were included in the non-occurrence and occurrence groups, respectively. The immune status of the patients and the expression of tumor factor-related indicators in the two groups were compared, and the predictive value of the indicators for postoperative LM in patients with CC was analyzed.

RESULTS

Compared with the non-occurrence group, the expression of serum carcinoembryonic antigen (CEA), CA19-9, CA242, CA72-4 and CA50 in patients in the occurrence group were significantly higher, while the expression of CD3+, CD4+, CD8+, natural killer (NK) and CD4+/CD25 in patients in the occurrence group were significantly lower (P < 0.05). No significant difference was observed in other baseline data between groups (P > 0.05). Multivariate logistic regression model analysis revealed that the expressions of CEA, CA19-9, CA242, CA72-4, CA50, CD3+, CD4+, CD8+, NK, and CD4+/CD25 were associated with the LM in patients with CC. High expressions of serum CEA, CA19-9, CA242, CA72-4 and CA50, and low expressions of CD3+, CD4+, CD8+, NK, and CD4+/CD25 in patients with CC were risk factors for LM (OR > 1, P < 0.05). The receiver operating characteristic curve showed that the area under curve for CEA, CA19-9, CA242, CA72-4, CA50, CD3+, CD4+, CD8+, NK, and CD4+/CD25 in the prediction of LM in patients with CC were all > 0.80, with a high predictive value.

CONCLUSION

The expression of tumor factors and immune state-related indices in patients with CC is closely associated with the occurrence of LM.

Keywords: Colon cancer; Liver metastases; Immune status; Tumor factors; Predicted value

Core Tip: Postoperative liver metastasis (LM) in patients with colon cancer (CC) leads to a poor prognosis; therefore, monitoring the risk factors that affect postoperative LM in patients with CC is crucial to improving their prognosis. The anti-tumor immune system of the body includes cellular immunity mediated by T cells and their subsets. An imbalance in the proportion of these cells or abnormalities in their function lead to a disordered immune system and a variety of immune-mediated diseases. Therefore, a correlation between postoperative LM and immune function may occur in patients with CC.