CD3^+和CD4^+与CD8^+及CD19^+与乳腺癌术后化疗感染的关系

Relationship between CD3^+,CD4^+,CD8^+and CD19^+and infection of breast cancer patients after chemotherapy

目的探究乳腺癌术后化疗患者外周血CD3^+、CD4^+、CD8^+、CD(19)^+细胞变化情况及与感染的关系。方法回顾性分析中国人民解放军联勤保障部队第九八九医院82例行乳腺癌根治术治疗患者临床资料,根据患者化疗期间是否发生感染分为感染组(16例)和未感染组(66例),记录患者术后化疗前后外周血CD3^+、CD4^+、CD8^+、CD(19)^+细胞水平变化及术后化疗感染情况,比较两组患者化疗前外周血CD3^+、CD4^+、CD8^+、CD(19)^+细胞水平差异,使用受试者工作特征曲线(ROC)评估其对乳腺癌术后化疗感染的预测价值。结果患者化疗前后外周血CD3^+、CD4^+、CD(19)^+细胞水平比较,均为化疗前>化疗1个疗程>化疗3个疗程(P<0.05),CD8^+细胞水平比较则为化疗前<化疗1个疗程<化疗3个疗程(P<0.05)。16例感染患者以呼吸道感染为主(42.86%);病原菌以革兰阴性菌居多(39.13%)。感染组化疗前外周血CD3^+、CD4^+、CD(19)^+细胞水平均低于未感染组(P<0.05),CD8^+细胞水平则高于未感染组(P<0.05),且外周血CD3^+、CD4^+、CD8^+、CD(19)^+细胞水平对乳腺癌术后化疗感染均具有较高预测价值。结论化疗前检测外周血CD3^+、CD4^+、CD8^+、CD(19)^+细胞水平,对预测乳腺癌术后化疗期间感染有积极意义。

OBJECTIVE To explore the relationship between peripheral blood CD3+,CD4+,CD8+and CD19+cells and infection of breast cancer patients after chemotherapy.METHODS The clinical data of 82 patients who underwent radical resection of breast cancer in No.989 Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army were retrospectively analyzed.The enrolled patients were divided into the infection group with 16 cases and the non-infection group with 66 cases according to the status of infection during the chemotherapy.The levels of peripheral blood CD3+,CD4+,CD8+and CD19+were recorded before and after postoperative chemotherapy,the incidence of infection was also recorded after the postoperative chemotherapy;the levels of peripheral blood CD3+,CD4+,CD8+and CD19+were compared between the two groups of patients before chemotherapy,and receiver operating characteristic(ROC)curve was used to evaluate the value of the above indexes in prediction of infection after breast cancer chemotherapy.RESULTS The levels of peripheral blood CD3+,CD4+and CD19+of the patients were significantly higher before chemotherapy than after 1 course of chemotherapy than 3 courses of chemotherapy(P<0.05),while the CD8+level was significantly lower before chemotherapy than after 1 course of chemotherapy than 3 courses of chemotherapy(P<0.05).Among 16 patients with infection,42.86%had respiratory tract infection.Gram-negative bacteria were dominant among the pathogens,accounting for 39.13%.The levels of peripheral blood CD3+,CD4+and CD19+of the infection group were lower than those of the non-infection group(P<0.05)while the CD8+level of the infection group was higher than that of the non-infection group(P<0.05),and the peripheral blood CD3+,CD4+,CD8+and CD19+had high value in prediction of infection in the breast cancer patients after chemotherapy.CONCLUSION The detection of peripheral blood CD3+,CD4+,CD8+and CD19+before chemotherapy has positive significance in prediction of infection in breast cancer patients after chemotherapy.