外周血细胞免疫指标在肺癌患者病情评估及化疗中的意义分析

Analysis on the significance of peripheral blood cellular immune indexes in the evaluation of diseases and chemotherapy of lung cancer

目的:分析外周血细胞免疫指标在肺癌患者病情评估及化疗中的意义。方法:选取2016年10月~2019年10月在院的106例非小细胞肺癌(NSCLC)患者作为病例组,选取同期100名体检者作为对照组;根据接受化疗治疗的患者在第2个化疗疗程末的疗效将其分为缓解组和未缓解组。对病例组和对照组研究对象的外周血CD3^(+)T淋巴细胞比例、CD4^(+)T淋巴细胞比例、CD8^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值、NK细胞比例、Th17细胞比例、Treg细胞比例等细胞免疫指标进行检测和分析;对缓解组和未缓解组患者化疗前后的上述指标水平进行检测和分析。结果:病例组患者的外周血CD3^(+)T淋巴细胞比例、CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值、NK细胞比例均低于对照组,外周血CD8^(+)T淋巴细胞比例、Th17细胞比例、Treg细胞比例均高于对照组,差异均有统计学意义;在病例组中,Ⅰ~Ⅱ期患者的外周血CD3^(+)T淋巴细胞比例、CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值、NK细胞比例均高于Ⅲ~Ⅳ期患者,外周血CD8^(+)T淋巴细胞比例、Th17细胞比例、Treg细胞比例均低于Ⅲ~Ⅳ期患者,差异均有统计学意义;有71例行化疗治疗,其中,缓解组43例,未缓解组28例。缓解组患者化疗前、后的外周血CD4^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)T淋巴细胞比值、NK细胞比例、Th17细胞比例、Treg细胞比例的改善幅度均高于未缓解组,差异均有统计学意义。结论:NSCLC患者表现为细胞免疫功能下降和自身免疫损害增强,不同临床分期患者的外周血细胞免疫指标具有明显的差异,化疗敏感性好的患者在化疗后细胞免疫指标会得到显著改善,针对外周血细胞免疫指标的检测可用于辅助肺癌的诊断、病情评价和化疗疗效预测。

Objective To analyze the significance of peripheral blood cellular immune indexes in the evaluation of diseases and chemotherapy of lung cancer.Methods 106 patients with non-small cell lung cancer(NSCLC)from October 2016 to October 2019 were selected as the case group,and 100 physical examinees at the same period were selected as the control group.According to the effects of chemotherapy at the end of the second chemotherapy course,the patients treated with chemotherapy were divided into the remission group and the non remission group.The peripheral blood cellular immune indexes such as CD3^(+)T lymphocyte percentage,CD4^(+)T lymphocyte percentage,CD8^(+)T lymphocyte percentage,CD4^(+)/CD8^(+)T lymphocyte ratio,NK cell percentage,Th17 cell percentage,Treg cell percentage between subjects in the case group and the control group were detected and analyzed;The above indexes before and after chemotherapy between the patients in the remission group and the non remission group were detected and analyzed.Results CD3^(+)T lymphocyte percentage,CD4^(+)T lymphocyte percentage,CD4^(+)/CD8^(+)T lymphocyte ratio,NK cell percentage in the peripheral blood of the patients in the case group were lower than those in the control group,and CD8^(+)T lymphocyte percentage,TTh17 cell percentage,Treg cell percentage of the patients in the case group were higher than those in the control group,the differences were statistically significant.In the case group,CD3^(+)T lymphocyte percentage,CD4^(+)T lymphocyte percentage,CD4^(+)/CD8^(+)T lymphocyte ratio,NK cell percentage in the peripheral blood of the patients in stageⅠ~Ⅱwere higher than those of the patients in stageⅢ~Ⅳ,and CD8^(+)T lymphocyte percentage,TTh17 cell percentage,Treg cell percentage of the patients in stageⅠ~Ⅱwere lower than those of the patients in stageⅢ~Ⅳ,the differences were statistically significant.There were 71 cases treated with chemotherapy,43 cases were included into the remission group and 28 cases were included into the non remission group.The improvements of CD4^(+)T lymphocyte percentage,CD4^(+)/CD8^(+)T lymphocyte ratio,NK cell percentage,Th17 cell percentage,Treg cell percentage between before and after the chemotherapy of the patients in the remission group were significantly higher than those in the non remission group,the differences were statistically significant.Conclusions The patients with NSCLC show decreased cellular immune functions and increased autoimmune damages.The peripheral blood cellular immune indexes of the patients with different clinical stages have obvious differences.The cellular immune indexes of the patients with good chemosensitivity will be significantly improved after chemotherapy.The detection of peripheral blood cellular immune indexes can be used to assist the diagnosis,diseases evaluation and chemotherapy effect prediction of lung cancer.