CD3^+CD4^+T细胞和CD3^+CD8^+T细胞水平与晚期非小细胞肺癌患者预后的关系

Relationship between Levels of CD3^+CD4^+T cells and CD3^+CD8^+T cells and the Prognosis of Patients with Advanced Non-small Cell Lung Cancer

【目的】探讨外周血辅助性T细胞CD3^+CD4^+、抑制/细胞毒性T细胞CD3+CD8+水平与晚期非小细胞肺癌(NSCLC)患者预后的关系。【方法】回顾性分析180例晚期NSCLC患者的临床资料。所有患者均接受培美西塞+奈达钳的化疗方案,持续2个化疗周期。收集患者化疗后外周静脉血标本,测定T淋巴细胞亚群(CD3^+CD4^+、CD3^+CD8^+)水平。采用多因素Logistic回归分析法分析患者近期预后的独立衫响因素,观察CD3^+CD4^+、CD3^+CD8^+水平与患者近期预后的关系。【结果】180例惠者治疗2个化疗周期后,部分缓解(PR)43例(23.89%),疾病稳定(SD)116例(64.44%),均纳入疾病控制组;疾病进展(PD)21例(11.67%),纳入疾病未控制组。疾病控制组KPS评分≥80分、肿瘤直径玄5cm、分化程度为低分化、TNM分期处于Ⅳ期、血小板计数≥300×10^9/L所占比例均显著低于疾病未控制组(P<0.05),CD3^+CD4^+,CD3^+CD8^+水平均显著高于疾病未控制组(P<0.05).多因素Logistic回归分析显示,KPS评分、肿瘤直径、分化程度、TNM分期、血小板计数外是晚期NSCLC患者近期预后的独立影响因素(P<0.05),而CD3^+CD4^+、CD3^+CD8^+水平并非是患者近期预后的独立影响因素(P>0.05)。【结论】晚期NSCLC癌化疗近期疗效与CD3^+CD4^+、CD3^+CD8^+水平无明显相关性,提示通过检測外周血T淋巴细胞亚群不能作为判断化疗疗效向依据。

【Objective】To study the relationship between the levels of CD3^+CD4^+T cells and CD3^+CD8^+T cells and the prognosis of patients with advanced non-small cell lung cancer(NSCLC).【Methods】One hundred and eighty patients with advanced NSCLC cancer were treated in our hospital.All patients received PG chemotherapy(Pemetrexed^+Nedaplatin)for 2 cycles.Peripheral venous blood samples of patients after chemotherapy were collected,and the levels of T lymphocyte subsets(CD3^+CD4^+,CD3^+CD8^+)were determined.Multivariate logistic regression analysis was used to analyze the independent influencing factors of patients'short-term prognosis and to observe the relationship between the levels of CD3^+CD4^+,CD3^+CD8^+ and patients'short-term prognosis.【Results】After two chemotherapy cycles of 180 patients,43 cases(23.89%)of PR and 116 cases(64.44%)of SD were found and were included in the disease control group,while 21 cases(11.67%)of PD were included in the disease uncontrolled group;the proportion of KPS score≥80,tumor diameter≥5cm,low differentiation,TNM stageⅣ,platelet count≥300×10^9/L in the disease control group were significantly lower than those in the disease uncontrol group(P<0.05);the levels of CD3^+CD4^+,CD3^+CD8^+ were significantly higher than those of the disease uncontrol group(P<0.05).Multivariate logistic regression analysis revealed that KPS score,tumor diameter,degree of differentiation,TNM stage and extra-platelet count were independent influencing factors for the recent prognosis of patients with advanced NSCLC(P<0.05),whereas CD3^+CD4^+,CD3^+CD8^+ levels were not independent influencing factors for the recent prognosis of patients(P>0.05).【Conclusion】The recent efficacy of chemotherapy for advanced NSCLC cancer is not significantly correlated with CD3'CD4^+,CD3^+CD8^+ levels,suggesting that detection of peripheral blood t lymphocyte subsets could not serve as a basis for judging the efficacy of chemotherapy.