放射治疗对肿瘤患者外周血T淋巴细胞亚群影响的Meta分析

Effect of Radiotherapy on Peripheral Blood T Lymphocyte Subsets in Cancer Patients:A Meta-Analysis

目的用Meta分析方法研究放射治疗前后肿瘤患者的外周血液T淋巴细胞亚群变化。方法系统地检索Cochrane图书馆、Pubmed、万方数字化期刊全文数据库、中国知网、维普等建库至2021年5月的相关数据,有关放射治疗和免疫功能的所有文献,对符合标准的队列研究共13篇文献包括852例患者的CD8+T细胞、CD4+T细胞、NK细胞百分比数据采用Stata14软件进行Meta分析。结果恶性肿瘤患者放疗后外周血CD8+T比例升高、CD4+T比例下降,差异有统计学意义[95%CI3.01(1.46~4.55),P=0.000;95%CI-4.57(-6.38~2.77),P=0.000]。而NK细胞比例治疗前后差异无统计学意义[95%CI0.07(-3.2~3.34),P=0.966]。结论放射治疗对肿瘤患者外周血T细胞亚群比例变化可能存在影响,但治疗结束1个月后患者免疫功能可能已经开始恢复,对于治疗后患者免疫状态及疗效判断方面有一定的参考作用。

Objective To study the changes of peripheral blood T lymphocyte subsets of tumor patients before and after radiotherapy by Meta-analysis.Methods The Cochrane Library,Pubmed,Wanfang Database,CNKI,Weipu and other relevant data from inception through the May 2021 were systematically searched.A total of 13 studies which included the percentage data of CD8+T cells,CD4+T cells,and NK cells of 852 patients.The Meta-analysis was performed using stata 14 software.Results CD8+T ratio increased and CD4+T ratio decreased in patients with malignant tumors after radiotherapy,the difference was statistically significant[95%CI 3.01(1.46-4.55),P=0.000;95%CI-4.57(-6.38--2.77),P=0.000].But there was no significant difference in the proportion of NK cells before and after treatment[95%CI 0.07(-3.2-3.34),P=0.966].Conclusion Radiotherapy may have an effect on the changes in the proportion of T cell subsets in the peripheral blood of tumor patients,but the immune function may have begun to recover after one month of the treatment,which has a certain reference for the immune status and efficacy judgment of patients after treatment.