晚期非小细胞肺癌患者化疗前后淋巴细胞亚群的变化  

Analysis on the changes of lymphocyte subsets among colorectal carcinoma patients before and after the chemotherapy

作　　者：吴云波[1] 张维强 魏智民 张国庆[1] 刘哲峰[1] 焦顺昌[1] Wu Yunbo;Zhang Weiqiang;Wei Zhimin;Zhang Guoqing;Liu Zhefeng;Jiao Shunchang(Department of Clinical Oncology,General Hospital of PLA,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院肿瘤科,北京100853 [2]中央军事委员会联合参谋部警卫局保健处

出　　处：《中国临床保健杂志》2018年第3期389-394,共6页Chinese Journal of Clinical Healthcare

基　　金：中央保健委保健专项科研课题(14BJZ47)

摘　　要：目的分析125例晚期非小细胞肺癌(NSCLC)患者2周期一线化疗前后21项淋巴细胞亚群变化情况。方法用三标荧光抗体对125例NSCLC患者接受紫杉^+铂类、培美曲塞^+铂类或其他方案2周期一线化疗前后外周血21项淋巴细胞亚型进行标记,流式细胞仪检测并分析结果,用SPSS 17.0软件统计分析化疗前后淋巴细胞亚群的变化,并分析不同化疗方案对淋巴细胞亚群的影响是否存在差异。结果晚期NSCLC患者化疗后CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD4^+CD29^+、CD3^+HLA-DR^+、45RO^+、CD4^+CD45RA^+、CD4^+CD45RO^+、CD28^+、CD8^+CD28-细胞在外周血淋巴细胞中的百分比例较化疗前明显升高,自然杀伤细胞(CD3-CD16^+或56^+)、CD19^+细胞百分比则明显降低(P<0.05)。亚组分析结果显示接受不同化疗方案化疗后患者CD19^+、CD25^+、Treg这三种淋巴细胞亚群在外周血中的百分比存差异有统计学意义(P<0.05);紫杉^+铂类组CD19^+细胞百分比最低,培美^+铂类组则最高;培美^+铂类组CD25^+和Treg细胞的百分比最低,其他化疗方案组则最高;除上述三种淋巴细胞亚群外,其余亚群在外周血中的百分比在不同化疗方案组患者之间差异无统计学意义(P>0.05)。结论 2个周期一线化疗使得晚期NSCLC患者体液免疫功能下降,但患者的细胞免疫功能处于增强状态;紫杉^+铂类方案对患者的体液免疫功能的减低作用相对明显,而培美曲塞^+铂类方案对机体的免疫抑制作用要低于紫杉^+铂类方案以及其他化疗方案。Objective To investigate the differences of 21 lymphocyte subsets before and after 2 cycles of chemotherapy in patients with advanced non-small cell lung cancer （NSCLC） patients. Methods 21 peripheral blood lymphocyte subsets from 125 advanced non-small cell lung cancer patients before and after 2 cycles of first-line chemotherapy drugs of paclitaxel with cisplatin or carboplatin （TC/TP）,pemetrexed with cisplatin or carboplatin （PC/PP） or other chemotherapy regimens were detected by three immune-fluorescence staining and the flow cytometry （FCM）.The differences of these lymphocyte subsets percentage were analyzed statistically with SPSS 17.0 software. Results After chemotherapy,the percentage of CD3 ＋,CD3 ＋CD4 ＋,CD3 ＋CD8 ＋,CD4 ＋CD29 ＋,CD3 ＋HLA-DR ＋,45RO ＋, CD4 ＋CD45RA ＋ ,CD4 ＋CD45RO ＋,CD28 ＋,CD8 ＋CD28 - cells in peripheral blood of advanced NSCLC patients were significantly increased,while the percentage of NK （CD3 -CD16 ＋ or 56 ＋） and CD19 ＋ cells was significantly decreased compared to that before chemotherapy （ P 〈0.05）.After chemotherapy,the percentage of CD19 ＋ cells was notably low in the TC/TP group compared with that in the PC/PP group and other chemotherapy groups,while it was notably high in the PC/PP group compared with that in TC/TP group and other chemotherapy groups （ P 〈0.05）.The percentage of CD25 ＋ and T reg cells was decreased significantly in PC/PP treatment group,and increased significantly in other chemotherapy groups（ P 〈0.05）.In addition,there were no significant differences in the percentage of other lymphocyte subsets in different chemotherapy groups. Conclusions 2 cycles of first-line chemotherapy drugs lowered the humoral immune ability and enhanced the cellular immune ability of the advanced NSCLC patients.The suppression of TC/TP chemotherapy regimen on humoral immunity is more notable compared to PC/PP chemotherapy regimen.The immunosuppressive effect of PC/PP is weaker than TC/TP.

关 键 词：癌 非小细胞肺 抗肿瘤联合化疗方案 淋巴细胞亚群 免疫系统现象 

分 类 号：R734.2[医药卫生—肿瘤]