Study On The Correlation Between Clinically Used Immune Factors (Indicators) And The Prognosis Of Ovarian Cancer Patients

Objective:To investigate the relationship between cellular immunity factors(CD3~+,CD4~+,CD8~+,ratio of CD4~+to CD8~+,CD16~+CD56~+,CD19~+)or humoral immunity factors(IgG,IgM,IgA,C3,C4,CRP,hs-CRP)in peripheral blood of ovarian cancer patients with clinicopathological factors,prognosis and recurrence of ovarian cancer,so as to provide clinical predictive indicators for the prognosis and recurrence of ovarian cancer patients.Methods:We analyzed the medical records of 105 patients with ovarian cancer who were treated in the Cancer Hospital of Guangxi Medical University firstly from 2011 to 2018 retrospectively.At last,we found the relationship between variation in cellular or humoral immune indexes before and after treatment and clinicopathological factors,prognosis,as well as recurrence.Results:1.Patients with high expression of CD4~+/CD8~+before treatment and low expression of CD3~+after treatment are mostly the patients who are aged more than 50 years old.Compared with the patients who are less than 50 years old,CD4~+expression before treatment of the patients more than 50 years old has a higher rank which is a observation of grade data in accordance with sequence.The high levels of CD8~+before treatment and CD3~+after treatment are mostly for patients50 less years old,but high levels of CD4~+/CD8~+before treatment are mostly for patients who are more than 50 years old;2.The patients who have a positive expression of CRP before treatment is mostly advanced ones;3.The ovarian cancer patients with endometrioid adenocarcinoma have the highest NK cell level after treatment and the lower expression rank on C3 before treatment than that of mixed cancer;4.Most patients with positive CRP before treatment and CD8~+normal expression after treatment are G3;5.The increase of IgG after treatment is negatively correlated with refractory platinum.The patients who has a increase of IgG after treatment experience a lower risk of platinum refractory.The OR value is 0.090 times that of patients with IgG reduction less than 1.49 g/L after treatment.Federation international of gynecology and obstetrics staging is positively correlated with platinum refractory.The risk of platinum refractory in advanced patients is 6.349 times that of early patients;6.Pathological grade and variation of IgG are related to the death of ovarian cancer.The risk of death in patients with G3 is significantly greater than that in patients with G1and G2(HR=6.450,95%CI:1.365-30.467).The patients who has a reduction of IgG above 1.49 g/L(HR=0.191,95%CI:0.048-0.760)or a rise(HR=0.133,95%CI:0.030-0.589)after treatment experience a lower risk of death than a decrease of no more than 1.49 g/L.The decrease of IgG above 1.49 g/L and increase are independent protective factors for ovarian cancer patients’death;7.International federation of gynecology and obstetrics staging,B-cell expression before treatment and variation of NK cell and hs-CRP variation after treatment are independent influencing factors for ovarian cancer recurrence:compared with early patients,advanced patients have a higher risk of relapse,(HR=5.811,95%CI:1.623-20.806);Before treatment,patients with normal(HR0.225,95%CI:0.058-0.874)and high(HR 0.032,95%CI:0.002-0.467)expression of B cells have a lower risk of recurrence than those with low expression.Compared with the group who’s NK cells get a decrease less than 3.1%,the group that get a decrease above 3.1%experiences a lower risk of recurrence(HR=0.064,95%CI:0.007-0.576).The risk of recurrence to patients with an increase less than 5.98 mg/L(HR 0.015,95%CI 0.001-0.318)or a decrease less than 1.02 mg/L(HR 0.012,95%CI 0.001-0.211)after treatment is significantly lower than the patients with an increase above 5.98mg/L;8.In random forest recurrence prediction model which is build by the variation of hs-CRP and NK cell after treatment,as well as the expression of B cell before treatment,the Model 4’s AUC value is 0.690,a advantage characteristic,with accuracy rate of 70.0%,sensitivity of 42.9%,specificity of75.0%.Variation of hs-CRP after treatment,increase above 5.98 mg/L,is the greatest effect factor in the recurrence of ovarian cancer;Conclusion:The increase of IgG after treatment is negatively correlated with refractory platinum.The patients who has a increase of IgG after treatment experience a lower risk of platinum refractory.The OR value is 0.090 times that of patients with IgG reduction less than 1.49 g/L after treatment.The decrease of IgG>1.49 g/L and increase after treatment are independent protective factors for the death of patients with ovarian cancer.B cell expression before treatment,variation of NK cell and hs-CRP after treatment constructing a prediction model can effectively predict ovarian cancer recurrence.The variation of hs-CRP has the advantage evalue in predicting ovarian cancer recurrence.The normal and high expression of B cells before treatment,the decline of NK cells>3.1%,and the increase of hs-CRP≤5.98 mg/L and decrease≤1.02 mg/L are independent protective factors for ovarian cancer recurrence.