非小细胞肺癌患者外周血淋巴细胞亚群水平检测临床意义

Expression of peripheral lymphocytes subsets and its clinical significance in patients with non-small cell lung cancer

目的人体的免疫功能在抗肿瘤免疫应答中发挥着重要作用,非小细胞肺癌(non-small cell lung cancer,NSCLC)患者免疫功能低下,可以在外周血淋巴细胞亚群水平中体现。本研究旨在探讨NSCLC患者外周血淋巴细胞亚群水平及其临床意义。方法选取2014-02-18-2017-02-06山东省肿瘤医院收治的102例NSCLC患者作为肺癌组,以同期该院45名健康体检者作为对照组。采用流式细胞仪检测2组受试者外周血中CD3^+、CD4^+、CD8^+、自然杀伤细胞(natural killer cells,NK)和调节性T细胞(regulatory T cells,Treg)水平,同时对肺癌患者不同临床病理因素中外周血淋巴细胞亚群水平进行比较。结果NSCLC患者外周血中CD3+细胞水平为(69.38±11.13)%,对照组为(74.86±5.61)%,差异有统计学意义,P<0.001;CD4+细胞水平为(38.08±9.75)%,对照组为(42.39±4.69)%,差异有统计学意义,P<0.001;NK细胞水平为(20.79±9.61)%,高于对照组的(16.14±6.19)%,P=0.004;Treg细胞水平为(3.13±1.17)%,高于对照组的(2.55±0.58)%,P<0.001。Ⅰ~Ⅱ期NSCLC患者外周血NK细胞水平高于Ⅲ、Ⅳ期NSCLC患者(P=0.031),而Treg细胞水平低于Ⅲ、Ⅳ期,P=0.013。肺鳞癌患者外周血NK细胞水平低于肺腺癌患者(P=0.043),Treg细胞水平高于肺腺癌患者,P=0.007。淋巴细胞亚群在不同分化肺癌患者之间差异无统计学意义,P>0.05。结论NSCLC患者外周血淋巴细胞亚群水平与NSCLC的发生和发展过程密切相关。NSCLC患者外周血淋巴细胞亚群,尤其是NK和Treg细胞水平检测,对了解机体免疫功能、评估病情和指导临床治疗具有重要的临床意义。

OBJECTIVE The immune function plays an important role in the anti-tumor immune process.The purpose of this study was to investigate the levels of peripheral blood lymphocyte subsets and its clinical significance in patients with non-small cell lung cancer(NSCLC).Poor immune function in patients with NSCLC can be reflected in the expression level of peripheral lymphocyte subsets.METHODS A total of 102 patients with NSCLC admitted to Shandong Cancer Hospital from February 18,2014 to February 6,2017 were selected as the study subjects,and 45 healthy people who underwent physical examination in the same period were taken as the control group.Flow cytometry was used to detect the levels of CD3^+,CD4^+,CD8^+,NK and Treg cells in peripheral blood of two groups of subjects.Meanwhile,the levels of peripheral lymphocytes subsets in patients with NSCLC in different clinicopathologic factors(stage,pathological type and differentiation)were compared and analyzed.RESULTS The levels of CD3+was(69.38±11.13)%in peripheral blood of patients with NSCLC and(74.86±5.61)%in the control group,there were statistical significance,P<0.001.The level of CD4+cells was(38.08±9.75)%,and that of the control group was(42.39±4.69)%,there were statistical significance,P<0.001.The level of NK cells was(20.79±9.61)%,higher than that of the control group(16.14±6.19)%,P=0.004.The level of Treg cells was(3.13±1.17)%,higher than that of the control group(2.55±0.58)%,P<0.001.The level of NK cells in peripheral blood of patients with stageⅠ-ⅡNSCLC was higher than that of patients with stageⅢandⅣNSCLC(P=0.031),while the level of Treg cells was lower than that of patients with stageⅢandⅣNSCLC,P=0.013.The levels of NK cells in peripheral blood of patients with lung squamous carcinoma was lower than that of patients with lung adenocarcinoma(P=0.043),while the levels of Treg cells was higher than that of patients with lung adenocarcinoma,P=0.007.There was no significant difference in lymphocyte subsets between patients with differentiated NSCLC,P>0.05.CONCLUSIONS The level of peripheral blood lymphocyte subsets in patients with NSCLC is closely related to the development and progression of NSCLC.The detection of peripheral blood lymphocyte subsets in patients with NSCLC,especially NK cells and Treg cells,is of great clinical significance in assessing the body immune function,evaluating the disease and guiding clinical treatment.