非小细胞肺癌患者记忆T细胞亚群分布情况及MIC-1、Survivin水平变化分析

Analysis of the distribution of memory T-cell subsets and changes in MIC-1 and Survivin in non-small cell lung carcinoma patients

目的研究非小细胞肺癌(NSCLC)患者记忆T细胞亚群分布情况及巨噬细胞抑制因子-1(MIC-1)、Survivin水平变化分析。方法回顾性选取2018年6月至2021年6月洪湖市中医医院收治的78例NSCLC患者作为试验组,选取同期78例肺部良性结节患者作为对照组。对比两组患者外周血中CD4^(+)T、CD8^(+)T细胞及其中T_(EM)和T_(CM)水平;对比两组患者血清MIC-1、Survivin水平;对比试验组患者不同病理特征(病理类型、分化程度、TNM分期、淋巴结转移、肿瘤大小)血清MIC-1、Survivin水平。结果试验组患者外周血单个核细胞内CD4^(+)T、CD8^(+)T细胞水平为(11.36±5.24)%、(14.88±2.85)%,显著低于对照组[(32.25±5.16)%、(33.65±2.47)%],差异均有统计学意义(P<0.05)。试验组患者外周血CD4^(+)T_(m)细胞和CD8^(+)T_(m)细胞中T_(EM)和T_(CM)水平为(66.48±10.48)%、(3.56±0.87)%、(71.05±5.65)%、(2.42±0.41)%,均显著低于对照组[(79.65±10.17)%、(4.98±0.91)%、(81.87±5.42)%、(4.69±0.51)%],差异均有统计学意义(P<0.05)。试验组患者血清MIC-1、Survivin水平为(1254.36±100.24)pg/mL、(51.63±5.47)ng/mL显著高于对照组[(687.62±101.65)pg/mL、(30.11±5.25)ng/mL],差异均有统计学意义(P<0.05)。TNM分期Ⅱ-Ⅲ期、低分化程度以及存在淋巴结转移患者血清MIC-1和Survivin水平均显著高于TNM分期I期、中高分化程度以及不存在淋巴结转移患者(P<0.05)。结论NSCLC患者外周血单个核细胞中CD4^(+)T、CD8^(+)T细胞明显降低,其中记忆淋巴细胞以T_(EM)为主;NSCLC患者血清MIC-1、Survivin水平显著升高,且与患者TNM分期、分化程度和淋巴结转移存在明显相关性。

Objective To analyze the distribution of memory T-cell subsets and changes in macrophage inhibitory cytokine 1(MIC-1)and Survivin in non-small cell lung carcinoma(NSCLC)patients.Methods Seventy-eight NSCLC patients admitted to Honghu Hospital of Traditional Chinese Medicine from June 2018 to June 2021 were retrospectively selected as experimental group,meantime,another 78 patients with benign pulmonary nodules during the same period were selected as control group.The levels of CD4^(+)T,CD8^(+)T,central memory T cells(T_(CM)),effector memory T cells(T_(EM))in peripheral blood were compared between groups,and serum levels of MIC-1 and Survivin were also compared between groups,moreover,comparison of serum MIC-1 and Survivin levels was also carried out among patients in experimental group with different pathological characteristics(pathological type,degree of differentiation,TNM stage,lymph node metastasis,tumor size).Results The levels of CD4^(+)T and CD8^(+)T cells in peripheral blood mononuclear cells of the experimental group were(11.36±5.24)%,(14.88±2.85)%,which were significantly lower than those of the control group[(32.25±5.16)%,(33.65±2.47)%],the differences were statistically significant(P<0.05).The proportions of CD4^(+)T_(CM),CD4^(+)T_(EM),CD8^(+)T_(CM) and CD8^(+)T_(EM) in corresponding T_(m) subsets of experimental group were(66.48±10.48)%,(3.56±0.87)%,(71.05±5.65)%,(2.42±0.41)%,which were significantly lower than those of control group[(79.65±10.17)%,(4.98±0.91)%,(81.87±5.42)%,(4.69±0.51)%],the differences were statistically significant(P<0.05).Serum levels of MIC-1 and Survivin in the experimental group were(1254.36±100.24)pg/mL,(51.63±5.47)ng/mL,which were remarkably higher than those of control group[(687.62±101.65)pg/mL,(30.11±5.25)ng/mL],the differences were statistically significant(P<0.05).Serum MIC-1 and Survivin levels were significantly higher in patients of TNM stage Ⅱ-Ⅲ,low differentiation and lymph node metastases than in patients of TNM stage I,moderate to high differentiation and no lymph node metastases,the differences were statistically significant(P<0.05).Conclusion Patients with NSCLC have significantly decreased CD4^(+)T and CD8^(+)T cells in peripheral blood PBMCs,furthermore,T_(EM) is the main memory T-cell subsets.Serum MIC-1 and Survivin levels are significantly elevated in NSCLC patients,and are closely correlated with TNM stage,differentiation degree and lymph node metastasis.