宫颈鳞状细胞癌患者化疗前后外周血淋巴细胞亚群表达临床意义

Differential expression of lymphocyte subsets in peripheral blood of patients with cervical squamous cell carcinoma pre- and post-chemotherapy and its clinical significance

目的探讨不同分期及化疗前后宫颈鳞状细胞癌患者外周血T细胞、B细胞和自然杀伤(NK)细胞亚群表达临床意义。方法选取2020-01-07-2021-01-20在山东省肿瘤医院进行化疗治疗的67例宫颈鳞状细胞癌患者为研究对象,采集患者化疗前后血样。采用流式细胞术检测外周血标本中淋巴细胞亚群分布,分析宫颈鳞状细胞癌患者治疗前后及不同分期淋巴细胞亚群表达水平。结果治疗前宫颈鳞状细胞癌患者CD4^(+)/CD8^(+)比值为1.80±1.09,高于治疗后的1.39±0.91,t=3.633,P=0.001;治疗前CD3^(+)CD4^(+)为44.09±12.97,高于治疗后的39.85±15.39,t=2.299,P=0.025;治疗前CD3^(-)CD19^(+)为12.75±8.23,高于治疗后的5.56±5.52,t=6.455,P<0.001;治疗前CD3^(-)CD16^(+)CD56^(+)为20.72±10.18,高于治疗后的16.10±9.99,t=3.231,P=0.002;治疗前CD3^(+)CD8^(+)为30.83±13.10,低于治疗后的36.63±15.20,t=2.367,P=0.001。治疗前,临床Ⅰ+Ⅱ期宫颈鳞状细胞癌患者CD3^(-)CD19^(+)为12.74±8.21,高于治疗后的4.43±4.32,t=5.07,P<0.001;治疗前,CD3^(-)CD16^(+)CD56^(+)为19.85±8.32,高于治疗后的13.03±7.64,t=3.420,P=0.001;治疗前,CD3^(+)为(78.72±8.74)%,低于治疗后的(85.12±9.61)%,t=2.790,P=0.010。治疗前,临床Ⅲ+Ⅳ期宫颈鳞状细胞癌患者CD4^(+)/CD8^(+)比值为2.09±1.24,高于治疗后的1.65±1.04,t=2.060,P=0.040;治疗前,CD3^(-)CD19^(+)为12.74±8.21,高于治疗后的4.43±4.32,t=3.470,P=0.001。结论宫颈鳞状细胞癌患者中晚期的T淋巴细胞亚群、B和NK淋巴细胞亚群水平异常,其中B和NK淋巴细胞亚群治疗前后变化明显,证实淋巴细胞亚群对宫颈鳞状细胞癌的诊断、化疗后病情评估和疗效判断具有一定参考价值。

Objective To investigate the expression of lymphocyte subsets in peripheral blood of patients with cervical cancer and its clinical significance.Methods From January 7,2020to January 20,2021,67patients with cervical squamous cell carcinoma received chemotherapy in Shandong Cancer Hospital Affiliated to Shandong First Medical University were selected as the research objects,and blood samples were collected before and after chemotherapy.The distribution of lymphocyte subsets in peripheral blood samples was detected by flow cytometry,the expression levels of lymphocyte subsets in patients with cervical squamous cell carcinoma before and after treatment and different stages were analyzed.Results The ratio of pre-treatment CD4^(+)/CD8^(+)(1.80±1.09)was higher than that of post-treatment(1.39±0.91),t=3.633,P=0.001.The pre-treatment CD3^(+)CD4^(+)(44.09±12.97)was higher than that of post-treatment(39.85±15.39),t=2.299,P=0.025.The pre-treatment CD3^(-)CD19^(+)(12.75±8.23)was higher than that of post-treatment(5.56±5.52),t=6.455,P<0.001.The pre-treatment CD3^(-)CD16^(+)CD56^(+)(20.72±10.18)was higher than that of post-treatment(16.10±9.99),t=3.231,P=0.002.The pre-treatment CD3^(+)CD8^(+)(30.83±13.10)was lower than that of post-treatment(36.63±15.20),t=2.367,P=0.001.In 32patients with clinical stageⅠ+Ⅱcervical squamous cell carcinoma,the CD3^(-)CD19^(+)before treatment(12.74±8.21)was higher than that after treatment(4.43±4.32),t=5.070,P<0.001.The pre-treatment CD3^(-)CD16^(+)CD56^(+)was higher(19.85±8.32)than post-treatment(13.03±7.64),t=3.420,P=0.001.The ratio of pre-treatment CD3^(+)(78.72±8.74)was lower than that in post-treatment(85.12±9.61),t=2.790,P=0.01.In 35patients with stageⅢ+Ⅳcervical squamous cell carcinoma,the pre-treatment CD4^(+)/CD8^(+)(2.09±1.24)was higher than that of post-treatment(1.65±1.04),t=2.060,P=0.040.The pretreatment CD3^(-)CD19^(+)(12.74±8.21)was higher than that of post-treatment(4.42±4.32),t=3.470,P=0.001.Conclusions The levels of T lymphocyte subsets,B lymphocyte subsets and NK lymphocyte subsets in patients with advanced cervical squamous cell carcinoma are abnormal,and the changes of B lymphocyte subsets and NK lymphocyte subsets before and after treatment are obvious.It confirmed that lymphocyte subsets have a certain reference value for the diagnosis of cervical squamous cell carcinoma,the evaluation of condition after chemotherapy and the judgment of curative effect.