非小细胞肺癌化疗前后T淋巴细胞亚群变化与化疗疗效相关性分析

Correlation analysis of T lymphocyte subgroup changes before and after chemotherapy with the chemotherapy effect in non-small cell lung cancer

目的 监测非小细胞肺癌（NSCLC）患者化疗前后外周血T淋巴细胞亚群变化,探讨患者化疗疗效与T淋巴细胞亚群变化的关系.方法 选取NSCLC患者42例为治疗组,另选同期体检者28例为对照组.所有NSCLC患者接受标准方案化疗,分别于化疗前、化疗2、4个疗程后检测患者T细胞亚群水平,每2个疗程评价化疗疗效.结果 与对照组相比,NSCLC患者CD3^＋（t=3.222,P〈0.01）、CD4^＋（t=9.655,P〈0.01）、CD4^＋/CD8^＋（t=10.657,P〈0.01）、NK淋巴细胞（t=5.310,P〈0.01）均明显下降,CD8^＋细胞显著升高（t=7.926,P〈0.01）,差异有统计学意义;患者不同性别、年龄之间T淋巴细胞变化差异无统计学意义.Ⅰ-Ⅱ期患者其CD4^＋（t=2.097,P〈0.05）,CD4^＋/CD8^＋（t=2.045,P〈0.05）免疫功能均好于Ⅲ-Ⅳ期患者,腺癌患者CD8^＋（t=2.015,P〈0.05）,CD4^＋/CD8^＋（t=2.315,P〈0.05）免疫功能好于鳞癌患者;患者接受化疗2-4个疗程后,T淋巴细胞亚群均得到全面地改善（P〈0.05）;患者化疗疗效与T淋巴细胞功能呈正相关,PR〉SD〉PD.结论 化疗可以改善NSCLC患者T淋巴细胞亚群免疫功能,并且疗效与患者T淋巴细胞表达有关,为临床上NSCLC患者进行适时、合理的免疫治疗提供理论依据.

Objective To monitor the changes of T lymphocyte subsets during chemotherapy in patients with non-small cell lung cancer（NSCLC）.Furthermore,to analyze the relationship between chemotherapy curative effect and the T lymphocyte subsets.Methods 42 cases with NSCLC were selected as the subjects,and 28 people undergoing health examination were selected as control group.All NSCLC patients just received NSCLC standard chemotherapy,then respectively determined T lymphocyte subsets at pre-chemotherapy and after 2,4 courses of chemotherapy.Every two cycles of chemotherapy we would evaluate the effect of chemotherapy.Results Before chemotherapy,the patients＇ CD3^＋（t=3.222,P〈0.01）,CD4^＋ （t=9.655,P〈0.01）,CD4^＋/CD8^＋ （t=10.657,P〈0.01） and NK lymphocytes （t=5.310,P〈0.01） were significantly decreased than those of the control group,and CD8^＋ lymphocytes （t=7.926,P〈0.01） increased significantly.There were no significant differences in patients＇ gender,age,but Ⅰ-Ⅱ period patients＇ CD4^＋（t=2.097,P〈0.05）,CD4^＋/CD8^＋（t=2.045,P〈0.05） immune function were better than Ⅲ-Ⅳ period patients.In patients with adenocarcinoma,CD8^＋（t=2.015,P〈0.05）,CD4^＋/CD8^＋（t=2.315,P〈0.05） immune function were better than squamous carcinoma.The patients received chemotherapy after 2,4 courses,the T lymphocyte subgroup was comprehensively improved （P〈0.01）.The curative effect of chemotherapy was positively correlated with T lymphocyte function,PR〉SD〉PD.Conclusion Chemotherapy can improve the NSCLC patients＇ T lymphocyte subgroup,and improve the situation related to the curative effect of chemotherapy.