化疗和分子靶向治疗对晚期非小细胞肺癌患者外周血PD-1表达的影响

Expression and significance of PD-1 in peripheral blood of patients with advanced NSCL

目的探索化疗和分子靶向治疗对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者外周血CD4+T细胞和CD8+T细胞上程序性死亡受体1(programmed cell death 1,PD-1)表达水平的影响。方法运用流式细胞术,检测2015年7月—2016年12月在空军特色医学中心(原空军总医院)肿瘤内科住院的51例晚期NSCLC初治患者在治疗前后外周血中CD4^+T和CD8^+T细胞上PD-1的表达水平。结果18例驱动基因阳性的晚期NSCLC患者经过1周期靶向治疗后,外周血中CD4^+T细胞和CD8^+T细胞上PD-1的表达分别与靶向疗前比较,差异无统计学意义(t=1.58,P=0.132;t=0.36,P=0.725);33例驱动基因野生型晚期NSCLC患者,经过1周期化疗后,CD4^+T细胞和CD8^+T细胞上PD-1的表达均低于化疗前;并发现驱动基因阳性的晚期NSCLC患者外周血CD4^+T细胞和CD8^+T细胞上PD-1的表达均低于驱动基因野生型的晚期NSCLC患者(t=2.17,P=0.035;t=2.27,P=0.028)。结论为化疗与免疫治疗联合应用提供了一定的理论依据,化疗与免疫治疗联合使用可能存在协同抗肿瘤的作用。

Objective To study the impact of chemotherapy and molecular targeted therapy on the expressions of PD-1 in CD4^+ T cells and CD8 + T cells in peripheral blood of patients with non-small cell lung cancer. Methods The expression levels of PD-1 in CD4^+ T and CD8^+ T cells in peripheral blood of 51 patients admitted to the Department of Oncology, Air Force Medical Center, between July 2015 and December 2016 were detected by flow cytometry. Results PD-1 expressions in CD4^+ T cells and CD8^+ T cells in peripheral blood hardly changed after one cycle of targeted therapy(t =1.58, P=0.132;t=0.36, P=0.725). After one-cycle chemotherapy, the expressions of PD-1 in CD4^+ T cells and CD8^+ T cells in peripheral blood of 33 patients with advanced NSCLC with wild-type driver genes declined. The expressions of PD-1 in CD4^+ T cells and CD8^+ T cells in peripheral blood of patients with advanced NSCLC with positive driver genes were found to be lower than those of patients with advanced NSCLC with wild-type driver genes(t=2.17, P=0.035;t=2.27, P=0.028). Conclusion The results of this study can contribute to the combined application of chemotherapy and immunotherapy. The combined use of chemotherapy and immunotherapy may have a synergistic anti-tumor effect.