非小细胞肺癌患者IMRT放疗后血清TGF-β1的变化及与T淋巴细胞亚群的关系研究

Study on the changes of serum TGF-β_1 and the relationship with T lymphocyte subsets in patients with non-small cell lung cancer after IMRT radiotherapy

目的观察非小细胞肺癌调强适形放射治疗(IMRT)后血清转化生长因子-β1(TGF-β1)和T淋巴细胞亚群变化及影响近期疗效的因素。方法前瞻性选取2014年6月至2017年9月我院收治的41例非小细胞肺癌患者作为研究对象。观察41名患者治疗后血清TGF-β1和T淋巴细胞亚群的变化,并分析二者之间的关系。分析影响非小细胞肺癌患者近期治疗疗效的危险因素。结果:IMRT放疗后血清TGF-β1变化不显著(P>0. 05); CD+3T细胞、CD+4T细胞、CD+8T细胞及CD+4T细胞/CD+8T细胞较治疗前比较,差异具有统计学意义(P <0. 05)。近期疗效较好患者治疗后血清TGF-β1表达水平降低。IMRT放疗后血清TGF-β1与CD+3T细胞、CD+4T细胞和CD+4T细胞/CD+8T细胞均成负相关,与CD+8T细胞成正相关。影响非小细胞肺癌患者近期治疗疗效的单因素结果显示,肿瘤分型、放疗剂量、放疗前血清TGF-β1水平及放疗后血清TGF-β1水平与近期疗效有关。多因素结果表明,中央型非小细胞肺癌、放疗剂量≥60 Gy、放疗前TGF-β1<2. 81 ng/m L和放疗后TGF-β1水平降低均提示近期疗效较好。结论非小细胞肺癌患者IMRT放疗后血清TGF-β1、T淋巴细胞亚群表达存在显著相关性,且近期疗效较好,患者治疗后血清TGF-β1表达水平降低。

Objective To observe the changes of serum transforming growth factor β1(TGF-β1) and T lymphocyte subsets and the factors influencing short-term efficacy in patients with non-small cell lung cancer after intensity-modulated radiation therapy(IMRT).Methods 41 patients with NSCLC from June 2014 to September 2017 were prospective selected as the subjects.The changes of serum TGF-β1 and T lymphocyte subsets were observed after treatment,and the relationship between serum TGF-β1 and T lymphocyte subsets was analyzed.The risk factors affecting the short-term therapeutic effect of NSCLC patients were analyzed.Results There was no significant change in serum TGF-β1 after IMRT radiotherapy(P>0.05).CD3^+T cells,CD4^+T cells,CD8^+T cells and CD4^+T cells/CD8^+T cells were significantly different before treatment(P<0.05).The expression level of serum TGF-β1 in patients with better therapeutic effect in the near future decreased.After IMRT radiotherapy,the level of serum TGF-β1 was negatively correlated with CD3^+T cells,CD4^+T cells and CD4^+T cells/CD8^+T cells,and was positively related to CD8^+T cells.Single factor results influencing the short-term therapeutic effect of non-small cell lung cancer showed that tumor classification,radiotherapy dose,serum TGF-β1 level before radiotherapy and serum TGF-β1 level after radiotherapy were related to short-term efficacy.Multivariate results showed that central type non-small cell lung cancer,radiotherapy dose more than 60 Gy,TGF-β1<2.81 ng/mL before radiotherapy and TGF-β1 decreased after radiotherapy showed good therapeutic effect.Conclusion There is a significant correlation between the expression of TGF-β1 and T lymphocyte subsets in patients with NSCLC after IMRT radiotherapy,and the expression of serum TGF-β1 in patients with better curative effect is lower after treatment.