肺癌患者淋巴细胞亚群在外周血中的表达及其与预后的关系

摘要

Background and objective Lung cancer is one of the most common malignancies.The aim of this study is to investigate the relationship between the change of lymphocyte subsets in the peripheral blood of lung cancer patients and the survival rate.Methods Flow cytometry was used to measure the percentages of lymphocyte subsets (CD3+, CD4+,CD8+, CD4+/CD8+, CD19+, CD25+, CD44+, and NK cells) in peripheral blood obtained from 221 patients with primary lung cancer without any treatment and from 96 healthy blood donors as the control group.The result was combined with clinical and follow-up data and statistical analysis was conducted.Results The levels of CD3+ and CD8+ in the patient group are significantly lower compared with the control group, whereas the levels of CD4+/CD8+, CDl9+, CD25+, CD44+, and NK cells are significantly higher (P＜0.05).CD8+ is significantly higher in the small cell lung cancer (SCLC) group compared with the nonsmall cell lung cancer (NSCLC) group.However, CD4+ and CD4+/CD8+ are lower in SCLC (P＜0.05).Ihere were no significant differences in different stages and differentiation (P＞0.05) in the NSCLC group.The level of CD3+ was significantly higher compared with the pre-chemotherapy group, but NK cell, CDl9+, and CD44+ were distinctly lower in the post-chemotherapy group (P＜0.05).More survival opportunities will be obtained for patients with no increase in CD44+ after chemotherapy (P=0.021), but the other three indices have no obvious influence on survival.Conclusion Widespread changes of lymphocyte occur in the peripheral blood of patients with lung cancer.There is a significant correlation between the change of CD44+ and the prognosis after chemotherapy%背景与目的 肺癌是最常见的恶性肿瘤之一,本研究旨在探讨肺癌患者外周血中淋巴细胞亚群的表达及与预后的关系.方法 采用流式细胞仪检测221例原发性肺癌首诊患者外周血淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+、CD19+、CD25+、CD44+及NK细胞所占比例,并与96例健康人的血标本对比,结合临床及随访资料进行统计分析.结果 与健康对照组对比,肺癌患者淋巴细胞亚群8项指标中CD3+及CD8+明显低于健康对照组,CD4+/CD8+、CD19+、CD25+、CD44+及NK细胞明显高于健康对照组(P<0.05).与非小细胞肺癌(non-small cell lung cancer,NSCLC)相比,小细胞肺癌(small cell lung cancer,SCLC)的CD8+明显升高而CD4+和CD4+/CD8+明显下降(P<0.05).化疗后与化疗前相比CD3+明显上升,NK细胞、CD19+及CD44+明显下降(P<0.05),其中CD44+在化疗后表达不升高者有生存优势(P=0.021),而其余3项指标与患者预期生存无关.结论 肺癌患者外周血淋巴细胞亚群普遍发生改变,CD44+在化疗后的改变可能与预后相关.