Relationship Between Immune Microenvironment Remodeling and Prognosis after Laparoscopic Radical Resection of Gastrointestinal Tumors

CHEN Jun; GUO Yirong; SHANGGUAN Shaohua; HUANG Xing

doi:10.3969/j.issn.2095-3097.2024.06.001

Abstract：Objective To investigate the relationship between immune microenvironment remodeling and prognosis in patients undergoing laparoscopic radical resection of gastrointestinal tumors.Methods A total of120 patients who underwent laparoscopic radical resection of gastrointestinal tumors at Nanping first hospital between Jan 2022 and Dec 2023 were en-rolled.Patients were divided into good prognosis group and poor prognosis group based on postoperative follow-up.Immune microenvironment remodeling indicators,including CD4+T cells,CD8+T cells,the CD4+/CD8+ratio,WBC,NLR,CRP,IL-6,TNF-α,PD-1,and PD-L1,were collected before surgery and at 1 month postoperatively.Multivariate logistic regression analysis was used to assess the relationship between these immune microenvironment remodeling indicators and postoperative prognosis.The predictive value of these factors for prognosis was compared.Results After surgery,the poor prognosis group had significantly higher levels of CD8+T cells,IL-6,TNF-α,PD-1,and PD-L1,and significantly lower levels of CD4+T cells and the CD4+/CD8+ratio compared to the good prognosis group (P<0.05).Multivariate logistic regression analysis in-dicated that the CD4+/CD8+ratio was a protective factor for poor prognosis,while IL-6,PD-1,and PD-L1 were risk factors (P<0.05).ROC curve analysis showed that the combined detection of the CD4+/CD8+ratio,IL-6,PD-1,and PD-L1 had high predictive value for prognosis,with AUC of 0.876.Conclusion Immune microenvironment remodeling is closely relat-ed to prognosis following laparoscopic radical resection of gastrointestinal tumors.The CD4+/CD8+ratio,IL-6,PD-1,and PD-L1 may serve as potential biomarkers for assessing patient prognosis.