血清胃泌素释放肽前体及外周血T细胞亚群水平与小细胞肺癌预后的相关性研究

Relationship between serum Pro GRIP and peripheral t-cell subsets and prognosis of small-cell lung cancer

目的研究血清胃泌素释放肽前体（Pro GRP）及外周血T细胞亚群水平与小细胞肺癌（SCLC）预后的相关性。方法将医院2017年1月至12月治疗的108例SCLC患者作为研究对象。入选者均接受顺铂＋依托泊苷（EP）方案化疗，化疗后4周评估临床疗效，并依据临床疗效评估标准将其分为PD组、SD组、有效组（CR＋PR组），同时测定患者ProGRP及外周血T细胞亚群水平。观察ProGRP、T细胞亚群水平与患者化疗疗效及预后的相关性。结果治疗前PD组、SD组、CR＋PR组ProGRP、CIM＋、CD8＋、CD4＋／CD8＋水平比较，差异未见统计学意义（P〉0．05）；与治疗前比较，治疗后SD组、CR＋PR组Pro GRP、CD8＋水平降低，CD4＋、CD4＋／CD8十水平升高，治疗后PD组ProGRP水平升高，CD4＋、CD4＋／CD8＋水平降低，差异有统计学意义（P〈0．05）；T细胞亚群升高组与降低组间近期无疾病进展生存率比较，差异朱见统计学意义（P〉0．05）；与ProGRP升高组比较，ProGRP降低组≥3个月无疾病进展生存率相对较高，差异有统计学意义（P〈0．05）。结论在监测SCLC患者化疗效果方面Pro GRP及T细胞亚群均具有一定的预测价值，但在预后评估方面Pro GRP更具优势。

Objective To study the relationship between serum gastrin-releasing peptide precursor （Pro GRP） and peripheral t-cell subsets and prognosis of small-cell lung cancer （SCLC）. Methods One hundred and eight cases of SCLC treated in hospital from January to December 2017 were studied. All patients received cisplatin plus etoposide （EP） chemotherapy, at 4 weeks after chemotherapy, the clinical curative effect was evaluated, and according to its clinical curative effect evaluation standard, the 108 patients were divided into PD group, SD group, effective group （CR ＋ PR group）, the levels of Pro GRP and T lymphocyte subsets in peripheral blood were measured simultaneously. The relationship between the levels of Pro GRP and T cell subgroup and the efficacy and prognosis of chemotherapy were observed. Results The levels of Pro GRP, CIM ＋ , CD8 ＋ , CIM ＋/CD8 ＋ in PD group, SD group and CR ＋ PR group before treatment were compared, and the differences were not significant （P 〉 0. 05 ）. Compared with before treatment, after treatment, the levels of Pro GRP and CD8 ＋ decreased and the levels of CIM ＋ and CIM ＋/CD8 ＋ increased in SD group and CR ＋ PR group, the level of Pro GRP increased and CD4 ＋ and CIM ＋/CD8 ＋ levels decreased in PD group. The differences were significant （P 〈 0. 05）. There was no significant difference in the progression free survival rate between the T cell subgroup and the lower group （ P 〉 0. 05）. Compared with the pro-grp group, the disease-free progression survival rate was relatively high in the pro-grp group at 3 months or more, and the difference was significant （P〈 0.05 ）. Conclusions Pro GRP and T cell subsets have certain predictive value in monitoring the effect of chemotherapy on SCLC patients, but Pro GRP has more advantages in prognosis evaluation.