NSCLC患者立体定向放射治疗后T淋巴细胞亚群、Treg及NK细胞亚群变化及意义

Change and clinical significance of T lymphocyte subsets,Treg and NK cell subsets in NSCLC patients after SBRT

目的分析非小细胞肺癌(NSCLC)患者立体定向放射治疗后T淋巴细胞亚群、调节性T细胞(Treg)及NK细胞亚群变化及临床意义。方法收集徐州医科大学附属医院2018年12月至2020年12月收治的92例NSCLC患者的临床资料,比较患者治疗前后T淋巴细胞亚群、Treg及与NK细胞水平。分析上述细胞水平与NSCLC临床病理特征的关系。并比较不同预后患者T淋巴细胞亚群、Treg及与NK细胞水平。绘制受试者工作特征曲线(ROC)分析上述细胞因子检测对NSCLC治疗后预后预测价值。结果治疗后,T淋巴细胞亚群水平均较治疗前增高,NK细胞、Treg水平较治疗前显著下降,差异均有统计学意义(P<0.05)。NSCLC患者不同年龄、性别、临床分期、病理分级、病理类型中T淋巴细胞亚群、NK细胞水平比较差异无统计学意义(P>0.05)。NSCLC临床分期Ⅰ~Ⅱ期、高中分化者Treg水平显著低于Ⅲ~Ⅳ期、低分化者,差异有统计学意义(P<0.05)。92例患者中,预后死亡19例(死亡组),生存73例(生存组),两组T细胞淋巴亚群、NK细胞比较差异无统计学意义(P>0.05);但生存组Treg水平显著低于死亡组,差异有统计学意义(P<0.05)。ROC结果显示,三者联合检测曲线下面积(AUC)为0.802,明显高于三者单独诊断(P<0.05)。结论立体定向放射治疗可调节T淋巴细胞亚群、Treg及NK细胞表达,通过联合检测上述细胞因子可进一步提高对NSCLC患者预后的预测能力。

Objective To analyze the change and clinical significance of T lymphocyte subsets,regulatory T cells(Treg)and NK cell subsets in patients with non-small cell lung cancer(NSCLC)after SBRT.Methods The clinical data of 92 NSCLC patients admitted to the Affiliated Hospital of Xuzhou Medical University from December 2018 to December 2020 were collected. The T lymphocyte subsets,Treg and NK cell levels of patients before and after treatment were compared. The relationship between the above-mentioned cell levels and the clinicopathological characteristics of NSCLC was analyzed. The levels of T lymphocyte subsets,Treg and NK cells in patients with different prognosis were compared. The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of the above-mentioned cell detection inevaluating the prognosis of NSCLC patients after treatment. Results After treatment,the level of T lymphocyte subsets increased compared with that before treatment,and the levels of NK cells and Treg cells significantly decreased compared with that before treatment,and the differences were statistically significant(P<0.05). There were no differences in T lymphocyte subsets and NK cell levels in NSCLC patients with different ages,genders,clinical stages,pathological grades,and pathological types(P>0.05). The Treg levels of NSCLC clinical stage Ⅰ~Ⅱ,high and moderately differentiated patients were significantly lower than those of Ⅲ~Ⅳ,poorly differentiated patients,and the difference was statistically significant(P<0.05). Among 92 patients,the prognosis of 19 patients died(death group)and 73 patients survived(survival group). There was no significant difference between the two groups of T cell lymphoid subsets and NK cells(P>0.05). However,the Treg cell level of the survival group was significantly lower than that of the death group,and the difference was statistically significant(P<0.05). ROC results showed that the area under curve(AUC)of the three combined detection was 0.802,which was significantly higher than that of the three detections alone(P<0.05).Conclusion Stereotactic radiotherapy can regulate the expression of T lymphocyte subsets,Treg and NK cells,and the combined detection of these cell subsets can further improve the prognosis of NSCLC patients.