非小细胞肺癌综合治疗期间免疫功能动态监测

Dynamic Surveillance on Immunity in Integrated Treatment for Patient with Non-small Cell Lung Cancer

[目的]对非小细胞肺癌(NSCLC)患者在手术、化疗及免疫治疗(口服百士欣)期间的外周血T细胞亚群及IL鄄2、sIL鄄2R进行动态监测及分析。[方法]首先在术前对54例确诊为NSCIC患者的上述指标进行检测并与20例健康人作对照。其中51例成功进行了肺叶或全肺切除术,于术后随机分为甲组(化疗加口服百士欣)和乙组(术后仅接受化疗)。两组病人均于术后1个月化疗前、术后2个月化疗后及术后6个月进行免疫指标检测。[结果](1)NSCLC患者术前CD3+,CD4+/CD8+,CD8+/CD28+,IL鄄2显著低于对照组,CD8+/CD28-、sIL鄄2R显著高于对照组。手术后上述指标分别显著回升或下降。(2)两组患者化疗前后上述指标无显著差异,甲组患者术后6个月与术后2个月化疗后有显著差异。(3)甲组和乙组组间比较,术后1个月化疗前及术后2个月化疗后上述指标无显著差异,术后6个月有显著差异。[结论](1)NSCLC患者处于免疫功能抑制状态,手术能恢复其免疫平衡;化疗对NSCLC术后患者的免疫功能可能无重要影响。(2)随着治疗时间的延长,百士欣可显著改善NSCLC患者术后免疫功能。

To investigate T-lymphocyte subsets,IL-2and sIL-2R in peripheral blood of NSCLC patient during the period of operation,chemotherapy and immunotherapy.The relevant immune indices were measured in54patients with NSCLC before operation,compared with20healthy cases simultaneously.Fifty-one among54patients successfully underwent lobectomy or pneumonectomy and were randomly divided into two groups:GroupⅠ(immunother-apy group)and GroupⅡ(only operation and chemotherapy).The relevant immune indices were all measured before chemotherapy and at the sixth month after chemotherapy.(1)Serum IL-2level,the percentage of CD 3+ ,CD 8+ CD 28+ ,and the ratio CD 4+ /CD 8+ of NSCLC patient were all significantly lower,while serum sIL-2R level and percentage of CD 8+ /CD 28- were higher than those of the healthy cases.These indices returned after operation.(2)All above-mentioned in-dices have significant differences at the sixth month after operation between the two groups while no significant changes at the first and second month after operation.[Conclusions](1)Immunity is significantly reduced in NSCLC patient and operation can improve immunity.(2)No significant immunity changes are found before and after chemotherapy.(3)Uben-imex can improve immunity of NSCLC patient after operation in a time-dependent manner.