中晚期非小细胞肺癌患者外周血淋巴细胞亚群特点分析

Characteristics of peripheral blood lymphocyte subsets in patients with middle-advanced non-small cell lung cancer

目的分析中晚期非小细胞肺癌(NSCLC)患者外周血淋巴细胞亚群的分布特点及临床意义。方法选择2022年1月至2023年4月收治的中晚期NSCLC患者93例,采用流式细胞术检测患者外周血总T、CD4^(+)T、CD8^(+)T、总B和NK细胞的比例及绝对值,分析其分布特征。结果58.06%的患者外周血淋巴细胞比例降低,35.48%的患者外周血淋巴细胞绝对值降低。流式分析显示,外周血T(84.95%)、B(76.34%)和NK(92.47%)细胞分布比例多处于正常范围,CD4^(+)/CD8^(+)比例异常占60.22%。外周血T(60.22%)、CD4^(+)T(58.06%)和CD8^(+)T细胞(64.52%)绝对值以降低为主,B细胞绝对值降低者占44.09%,NK细胞绝对值降低者占32.26%。腺癌患者外周血总T细胞比例显著低于鳞癌患者水平(P=0.047)。腺癌患者外周血NK细胞比例和绝对值均显著低于鳞癌患者水平(P值分别为0.0025、0.02)。其余指标在不同病理类型之间的分布差异无统计学意义(P>0.05)。结论中晚期NSCLC患者外周血免疫细胞减低,CD4^(+)/CD8^(+)比例失衡,NK细胞水平与NSCLC病理类型相关。

Objective To analyze the distribution characteristics and clinical significance of peripheral blood lymphocyte subsets in patients with middle-advanced non-small cell lung cancer(NSCLC).Methods Ninety-three middle-advanced NSCLC patients admitted to our hospital from January 2022 to April 2023 were studied.The proportions and absolute values of peripheral total T cells,CD4^(+)T cells,CD8^(+)T cells,total B cells and natural killer(NK)cells were measured by flow cytometry,and their distribution characteristics were analyzed.Results Blood routine examination showed that 58.06%of total patients had a lower percentage of peripheral blood lymphocytes,and 35.48%had a lower absolute value of peripheral blood lymphocytes.Flow cytometry analysis showed that the distribution of T(84.95%),B(76.34%),and NK(92.47%)cells in peripheral blood was mostly within the normal range.The abnormal CD4^(+)/CD8^(+)ratio was found in 60.22%of total patients.The absolute values of peripheral blood T(60.22%),CD4^(+)T cells(58.06%),and CD8^(+)T cells(64.52%)were mainly reduced.44.09%of patients showed a decrease in absolute values of B cells and 32.26%had decreased absolute values of NK cells.The proportion of total T cells in peripheral blood of adenocarcinoma patients was significantly lower than that of squamous cell carcinoma patients(P=0.047).The proportion and absolute value of NK cells in peripheral blood of adenocarcinoma patients were significantly lower than those of squamous cell carcinoma patients(P=0.0025 and 0.02,respectively).There was no significant difference in the distribution of other factors among different pathological types(all P>0.05).Conclusion Patients with middle-advanced NSCLC have decreased peripheral blood immune cells and imbalanced CD4^(+)/CD8^(+)ratio.NK cell number is correlated with the pathological type of advanced NSCLC patients.