原发性肺癌患者外周血PD-1淋巴细胞亚型检测与临床预后的关系研究

Predictive and Prognostic Value of PD-1 Expression and Lymphocyte Subsets in Peripheral Blood of Primary Lung Cancer Patients before Treatment

目的检测原发性肺癌患者外周血PD-1淋巴细胞亚型,并进行临床随访,分析其与临床预后的关系。方法采集2015年1月至2016年11月在河南省肿瘤医院呼吸内科诊治的35例可疑原发性肺癌患者的血液学标本,并进行外周血淋巴细胞亚型分析以及PD-1表达,然后进行临床随访。结果 35例患者中,31例患者最终病理确诊为原发性肺癌(腺癌23例,鳞癌3例,小细胞肺癌5例),剩余4例患者为炎症。CD3+CD8+T细胞比例数值高、CD4+/CD8+的比值低、PD-1+/PBMC比例高的患者近期疗效越好。未发现治疗前淋巴细胞亚型比例异常患者与正常患者之间存在PFS的差异。结论在本项回顾性小样本研究中,发现原发性肺癌治疗前特定淋巴细胞亚型与近期疗效相关,尤其是PD-1+PBMC比例升高的患者近期疗效更佳。需要进一步前瞻性大样本研究验证。

Objective This study aimed to investigate the proportions of lymphocyte subsets and the expression of PD-1in peripheral blood,and to analyze the associations between the proportion of PD-1＋lymphocyte subsets and clinical outcomes in the primary lung cancer patients.Methods Flow cytometry was used to measure the percentages of lymphocyte subsets and PD-1expression in periperal blood of patients clinically diagnosed as primary lung cancer from January 2015 to November 2016.The clinical data and follow-up data were collected and analyzed.Results 35 patients were enrolled and 31 patients were diagnosed as primary lung cancer,4patients were pulmonary inflammation.The percentages of CD3＋CD8＋ higher,CD4＋/CD8＋ratio lower and PD-1＋ PBMC elevated predicted better short-term efficacy.The abnormal percentages of lymphocyte subsets and PD-1expression were not statistically associated with PFS in survival analysis.Conclusion The proportions of specific peripheral blood lymphocyte subsets were associated with short-term efficacy,particularly in the elevated percentage of PD-1＋PBMC of primary lung cancer.Prospective and larger sample size study need to be conducted in the future.