支气管动脉灌注化疗对肺癌患者T细胞亚群及NK细胞的临床意义

摘要

Objective To study the changes of T-lymphocytes subsets and NK cells in patients with lung cancer before and after bronchical artery infusion chemotherapy (BAD and evaluate their clinical significance. Methods 30 cases of lung cancer patients were enrolled in the study. APAAP techniques was used to measure T-lymphocytes subsets and NK cells in peripheral blood respectively before BAI, two weeks after BAI and four weeks after BAI and compared them with that of 30 health controls. Results The findings showed that the percentages of CD8+ cells in patients were significantly higher than that in health controls. However, percentages of CD3+ cells, CD4 + cells, ratio of CD4+/CD8+ and the level of NK cells in patients were remarkably lower than that of health controls (P<0. 01). Two weeks after BAI, the T- lymphocytes subsets and the level of NK cells had no significant changes (P>0. 05). But the percentages of CD8+ cells significantly decreased , the percentages of CD3+ cells, CD4+ cells, ratio of CD4+ /CDs+ and the level of NK cells increased at four weeks after BAI. Conclusion The immune status in patients with lung cancer is compromised compared with the healthy controls. Application of BAI may restore immune function to a certain extent at four weeks after treatment. So clinical observation to the immunity of the patients with lung cancer has certain surveilant function on the treatment and prognosis of the lung cancer. It is reasonable that lung cancer patients receive the second BAI at four weeks after the first management.%目的 探讨肺癌患者支气管动脉灌注(BAI)化疗前后T细胞亚群及NK细胞的变化及临床意义.方法 选择30例肺癌患者,于支气管动脉灌注化疗前、化疗后2周、4周,采用碱性磷酶抗碱性磷酶(APAAP)法检测T细胞亚群及NK细胞的变化,并与30例健康者作对比分析.结果 肺癌患者CD8+细胞显著高于健康者,同时CD3+细胞、CD4+细胞、CD4 +/CD8+比值、NK细胞低于健康对照组(P＜0.0l).BAI治疗后2周T细胞亚群、NK细胞与治疗前比较未见明显变化(P＞0.05),治疗后4周CI3+细胞、CD4+细胞、CD1 +/CD8+比值、NK细胞升高,CD8+细胞下降(P＜0.01).结论 肺癌患者免疫功能较正常人低下,BAI治疗后4周有可能使肺癌患者免疫水平得到一定程度恢复,临床上观察细胞免疫功能对肺癌患者的BAI治疗和预后有一定的监测作用；接受BAI治疗的患者间隔4周后进行第二次治疗较为恰当.