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Background <p>While immune dysregulation significantly influences colorectal cancer (CRC) progression, this study aimed to investigate the levels of circulating regulatory T cells (cTreg) and their subsets, follicular helper T cells (cTfh), and follicular regulatory T cells (cTfr) in patients with CRC and to evaluate their prognostic significance.</p> Methods <p>We enrolled 120 patients with CRC (January 2021 to September 2022) and 91 healthy controls (HCs). Flow cytometry was used to quantify the frequency of cTregs and their subsets (resting Tregs/activated Tregs), cTfh, and cTfr. Patients were prospectively followed up until April 2025, with overall survival (OS) as the primary endpoint. Univariable and multivariable Cox proportional hazards models were employed to identify significant prognostic factors for OS. Survival curves were generated using the Kaplan–Meier method and compared with the log-rank test.</p> Results <p>After a 35-month median follow-up, 22 patients with CRC had died (18.3% mortality rate). Patients with CRC had higher cTreg (7.43% vs. 6.33%, <i>P</i> &lt; 0.001), cTfh (15.8% vs. 13.8%, <i>P</i> &lt; 0.001), and cTfr (2.39% vs. 2.20%, <i>P</i> = 0.019) than HCs. Patients with advanced-stage CRC had higher cTreg levels than those with early-stage CRC (7.68% vs. 7.10%, <i>P</i> = 0.006). Higher frequency of cTreg levels (≥ 8.295%, area under the curve = 0.717) was correlated with shorter OS.</p> Conclusions <p>cTreg, cTfh, and cTfr levels are elevated in patients with CRC. An elevated cTreg frequency is associated with poor CRC prognosis. Assessment of cTreg levels may aid in prognostic assessment.</p>

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Higher frequency of circulating regulatory T cells is associated with poor outcomes in patients with colorectal cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月18日

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  • Yan Lu,
  • Haoyang Guo,
  • Taotao Guo,
  • Longyi Zhang,
  • Xinling Pan

摘要

Background

While immune dysregulation significantly influences colorectal cancer (CRC) progression, this study aimed to investigate the levels of circulating regulatory T cells (cTreg) and their subsets, follicular helper T cells (cTfh), and follicular regulatory T cells (cTfr) in patients with CRC and to evaluate their prognostic significance.

Methods

We enrolled 120 patients with CRC (January 2021 to September 2022) and 91 healthy controls (HCs). Flow cytometry was used to quantify the frequency of cTregs and their subsets (resting Tregs/activated Tregs), cTfh, and cTfr. Patients were prospectively followed up until April 2025, with overall survival (OS) as the primary endpoint. Univariable and multivariable Cox proportional hazards models were employed to identify significant prognostic factors for OS. Survival curves were generated using the Kaplan–Meier method and compared with the log-rank test.

Results

After a 35-month median follow-up, 22 patients with CRC had died (18.3% mortality rate). Patients with CRC had higher cTreg (7.43% vs. 6.33%, P < 0.001), cTfh (15.8% vs. 13.8%, P < 0.001), and cTfr (2.39% vs. 2.20%, P = 0.019) than HCs. Patients with advanced-stage CRC had higher cTreg levels than those with early-stage CRC (7.68% vs. 7.10%, P = 0.006). Higher frequency of cTreg levels (≥ 8.295%, area under the curve = 0.717) was correlated with shorter OS.

Conclusions

cTreg, cTfh, and cTfr levels are elevated in patients with CRC. An elevated cTreg frequency is associated with poor CRC prognosis. Assessment of cTreg levels may aid in prognostic assessment.