肺癌射频消融治疗后CD4^+T细胞亚群的变化及其意义

Changes in CD4^+T-cell subsets after radiofrequency ablation in lung cancer and its significance

目的探讨肺癌射频消融(RFA)治疗对CD4+T细胞亚群的影响及其意义。方法选取2015年5月至2016年3月间北京大学深圳医院收治的45例采用RFA治疗的肺癌患者,检测肺癌患者RFA治疗前后外周血CD4+T细胞亚群,比较RFA治疗前后CD4+T细胞亚群的差别,分析临床病理特征及RFA治疗效果与CD4+T细胞亚群变化的相关性。结果 RFA治疗2周后,患者Th1细胞水平及Th1/Th2细胞比值较治疗前明显升高,Th2、Th17和Treg细胞水平较治疗前明显下降,差异均有统计学意义(均P<0.05)。Ⅰ~Ⅱ期、KPS评分≥60分及消融体积≥病灶70%患者RFA治疗后CD4+T细胞亚群的变化与Ⅲ~Ⅳ期、KPS评分<60分及消融体积<病灶70%患者比较,差异均有统计学意义(均P<0.05)。结论肺癌患者RFA治疗后机体抗肿瘤免疫功能得到改善,CD4+T细胞亚群的变化可作为肺癌RFA疗效评估及预后判断指标。

Objective To investigate the effects of radiofrequency ablation（ RFA） on CD4^＋Tcell subsets in lung cancer patients and its significance. Methods Forty-five patients who underwent RFA were selsected at Peking University Shenzhen Hospital from May 2015 to March 2016. CD4^＋T-cell subsets in the peripheral blood were detected. Differences in CD4^＋T-cell subsets before and after RFA were compared. The relationships between changes in CD4^＋T-cell subsets and clinicopathologic characteristics and therapeutic effectiveness were analyzed. Results The Th1 cell level and Th1/Th2 cell ratio significantly increased at 2 weeks after RFA than before RFA and the levels of Th2,Th17 and Treg significantly declined（ all P〈0. 05）. Significant differences were found in changes of CD4^＋T-cell between patients with stage Ⅰ/Ⅱ lung cancer,Karnofsky performance status（ KPS） ≥ 60 and ablation volume≥70% and patients with stage Ⅲ/Ⅳ lung cancer,KPS score 60 and ablation volume 70%（ all P〈0. 05）. Conclusion After RFA,anti-tumor immune response was improved. Changes in CD4^＋T-cell subsets can be considered as one of the factors in predicating the efficacy of RFA and the prognosis in lung cancer patients.