CD4^+、CD8^+T淋巴细胞表达对术后辅助放疗的非小细胞肺癌患者的预后意义  

CD4 expression shows prognostic value in non-small cell lung cancer with adjuvant radiotherapy

作　　者：胡静[1] 郑璐[1] 张欢乐[1] 张三典[1] 陆妙珍[1] 徐国栋[2] 李旎 叶爽 HU Jing;ZHENG Lu;ZHANG Huanle(Department of Radiotherapy,Lihuili Hospital of Ningbo Medical Center,Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利医院放疗科,315040 [2]宁波市医疗中心李惠利医院心胸外科,315040

出　　处：《浙江医学》2018年第7期712-716,共5页Zhejiang Medical Journal

基　　金：浙江省自然科学青年基金项目(LQ16H160002);宁波市自然科学基金(2016A610196)

摘　　要：目的探讨CD4^+、CD8^+T淋巴细胞在非小细胞肺癌(NSCLC)术后行辅助放疗患者中的表达情况及其对预后的预测价值。方法选择46例接受辅助放疗的Ⅱ~Ⅲ期NSCLC患者,收集患者的临床资料,应用免疫组化法,检测患者肿瘤组织、间质组织中CD4^+、CD8^+T淋巴细胞的表达情况。通过单因素与多因素分析,评估T淋巴细胞表达对NSCLC患者3年生存率的影响。结果NSCLC患者的年龄、组织学分化程度以及淋巴结分期与总生存时间相关(均P<0.05);肿瘤及间质组织中CD4及CD8表达与患者年龄、性别、病理类型、组织学分化程度及淋巴结分期等临床病理因素均无关(均P>0.05);肿瘤组织及间质组织高表达CD4者3年总生存率为52.94%、50.00%,间质组织高表达CD8者3年总生存率为61.11%,均明显高于低表达者(均P<0.05);多因素分析显示,肿瘤组织CD4高表达者的HR为0.048(P<0.01),是NSCLC患者3年总生存率的独立预测因子。结论高表达CD4^+T淋巴细胞可作为NSCLC术后患者是否选择辅助放疗的免疫标志物,肿瘤高表达CD4可以获得更好的预后。Objective To investigate the expression of CD4 and CD8 T- lymphocytes in non- small cell lung cancer（NSCLC） patients with adjuvant radiotherapy and its prognostic significance. Methods Forty six patients with stage Ⅱ- Ⅲ NSCLC who received adjuvant radiotherapy after surgery were enrolled in the study. The expression of CD4 and CD8 T lymphocytes in lung cancer tissue and stromal tissue were detected by immunohistochemical staining. Results The overall survival of patients was associated with age, gender, and histological differentiation of patients （P 〈0.05）. The expression of CD4 and CD8 lymphocytes in lung cancer tissue and stromal tissue were not correlated with age, gender, pathological type, histological differentiation and lymph node metastasis （P 〉0.05）. The 3- year overall survival rate of patients with high CD4 expression in tumor, in stromal tissue and high CD8 expression in stromal tissue were 52.94%, 50.00% and 61.11%, which was higher than that in patients with low expression （P〈0.05）. Cox analysis showed that high- CD4 expression in cancer tissue was an independent predictor for overall survival （HR=0.048, P〈0.01）. Conclusion High CD4-＋ expression in cancer tissue is associated with higher overall survival for patients with NSCLC receiving adjuvant radiotherapy after surgery.

关 键 词：非小细胞肺癌 CD4^+淋巴细胞 CD8^+淋巴细胞 放疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]