肺癌骨转移患者放疗前后HSP70水平和Treg比例变化及其与疗效的关系

Clinical significance of HSP70 and Treg alteration in lung cancer patients with bone metastasis treated with radiotherapy

目的观察肺癌骨转移患者放疗效果与生存期间关系,同时观察放疗前后患者CD3+CD8+T细胞比例、NK细胞比例、血清HSP70蛋白水平及Treg细胞比例的变化。方法观察30例肺癌骨转移患者,给予放射线治疗并观察其生存期。治疗前后取患者外周血标本检测患者外周血CD3+CD8+T细胞比例、NK细胞比例、HSP70蛋白及Treg细胞比例。结果放疗骨痛缓解组较未缓解组患者生存期明显延长,缓解组生存期为158.6±12.38天,未缓解组生存期为71.75±16.81天,统计学分析两组间研究对象生存时间存统计学差异,P=0.004。放疗骨痛缓解组血清HSP70蛋白水平由放疗前的4.52±1.83ng/ml降低至放疗后的2.87±0.92ng/ml,Treg细胞比例由放疗前的4.62±0.87降低至放疗后的2.68±0.65,差异有统计学意义,而未缓解组放疗前后无统计学差异。两组间CD3+CD8+T细胞比例、NK细胞比例在治疗前后均无明显变化。结论肺癌骨转移患者在接受放射治疗后联合免疫细胞治疗或能提高治疗效果。

Objective To observe the relationship between the radio-therapeutic effect and survival time in lung cancer patients with bone metastasis,and to observe the proportion of CD3 ＋CD8 ＋T cells and NK cells,the lev-el of HSP70 protein and the proportion change of Treg cells.Methods 30 cases were enrolled,and they were trea-ted with radiotherapy.Their survival time and proportion of CD3 ＋CD8 ＋T cells ,NK cells,HSP70 protein and Treg cells were observed before and after therapy.Results The survival time of the ostealgia remission group （158.6 ± 12.38days）after radio-therapeutic was significantly longer than the non-remission group （71.75 ±16.81days）（P =0.004）.The level of serum HSP70 protein in the ostealgia remission group reduced from 4.52 ±1.83ng/ml before radiotherapy to 2.87 ±0.92ng/ml after radiotherapy,meanwhile the proportion of Treg cells reduced from 4.62 ± 0.87 to 2.68 ±0.65 respectively.By contrast,the difference in the non-remission group had no statistical difference. The proportion of CD3 ＋CD8 ＋T cells and NK cells between the two groups had no significantly change with treatment finished.Conclusion Cell-based immune-therapy combined with radiotherapy can improve therapeutic effect for lung cancer patients with bone metastasis.