非小细胞肺癌患者外周血T细胞亚群、NK细胞与临床分期及预后的相关性

Correlation of the expression of T lymphocyte subsets and NK cells to clinical stage and prognosis in patients with non-small cell lung cancer

目的分析非小细胞肺癌(NSCLC)患者外周血T细胞亚群、NK细胞的表达,及其与临床分期及预后的相关性。方法采用流式细胞术检测96例NSCLC患者、30例肺部良性疾病及健康体检者外周血T细胞亚群、NK细胞的表达,分析其与肺癌临床分期的关系,对患者随访2年,比较化疗后不同表达水平之间的生存率。结果 NSCLC组患者CD+3、CD+4/CD+8及NK细胞比例较对照组和肺良性疾病组明显降低,而CD+8细胞比例则明显升高(P<0.05);Ⅲ-Ⅳ期NSCLC患者CD+3及NK细胞比例较Ⅰ-Ⅱ期患者明显降低,而CD+8细胞比例则明显升高(P<0.05);CD+3、CD+4/CD+8及NK细胞与临床分期呈负相关(r=-0.715、-0.673、-0.593,P<0.05),CD+8与临床分期呈正相关(r=0.672,P<0.05);CD+4/CD+8上升组化疗后2年生存率为82.0%,明显高于未上升组57.6%,差异均有统计学意义(P<0.05)。结论 NSCLC患者外周血T细胞亚群、NK细胞分布异常,且与临床分期密切相关,联合检测可客观反映免疫功能状态及病情程度,对NSCLC的治疗及预后具有一定的指导作用。

Objective To investigate the expression of T lymphocyte subsets and NK cells in patients with non-small cell lung cancer （ NSCLC） , and to analyze their relationship with clinical stage and prognosis. Methods The expression of T lymphocyte subsets and NK cells was detected in 96 patients with NSCLC, 30 patients with be-nign pulmonary disease and 30 healthy controls by flow cytometry. Their relationship with clinical stage was analyzed. All the patients were followed up for 2 years, and the survival rates after chemotherapy between different expression of T lymphocyte subsets and NK cells were compared. Results The proportions of CD3^＋, CD4^＋ /CD8^＋ and NK cells in NSCLC patients were significantly lower than those in the control group and patients with benign pulmonary disease, and the proportion of CD8^＋ increased remarkably （ P〈0. 05 ） . The proportions of CD3^＋ and NK cells at the clinical stage of Ⅲ-Ⅳ were lower, and CD8^＋ was higher than those at the clinical stage of Ⅰ-Ⅱ （P〈0. 05）. The level of CD3^＋, CD4^＋ /CD8^＋ and NK cells was negatively correlated with clinical stage （r= -0. 715, -0. 673, -0. 5931, P〈0. 05）, but the level of CD8^＋ was positively correlated with clinical stage in NSCLC patients （r =0. 672, P 〈0. 05）. The two-year survival rate after chemotherapy in patients with CD4^＋ /CD8^＋ increase was 82. 0%, which was significantly higher than 57. 6% in patients with no increase of CD4^＋ /CD8^＋（P〈0. 05）. Conclusion Abnormal dis-tribution of T lymphocyte subsets and NK cells occurs in NSCLC patients, and it is closely related with clinical sta-ges. The combined detection can objectively reflect the state of immune function and degree of condition, which shows some meaningful effect to the comprehensive treatment and prognosis.