高级别胶质瘤病人放化疗前后淋巴细胞亚群变化及意义  

Changes of lymphocyte subsets in patients with high grade glioma before and after chemoradiotherapy and its significance

作　　者：张洋洋 高劲 陶振超 何健 杨丽萍 杨婧 周燕 黄一凡 ZHANG Yangyang;GAO Jin;TAO Zhenchao;HE Jian;YANG Liping;YANG Jing;ZHOU Yan;HUANG Yifan(Department of Head and Neck Radiotherapy,The First Affiliated Hospital of USTC West District,Anhui Provincial Cancer Hospital,Hefei,Anhui 230031,China)

机构地区：[1]中国科技大学附属第一医院西区安徽省肿瘤医院头颈放疗科

出　　处：《安徽医药》2019年第10期2032-2035,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨高级别胶质瘤(high grade glioma,HGG)术后病人同步放化疗前后外周血淋巴细胞亚群变化及其对预后的影响。方法收集2012年6月至2017年7月间安徽省肿瘤医院收治的51例HGG术后病人为研究对象,检测同步放化疗前后病人外周血淋巴细胞亚群变化,并依据同步放化疗前CD4^+/CD8^+比值将病人分为CD4^+/CD8^+≥1及CD4^+/CD8^+<1两组,采用Ka?plan?Meier法计算无进展生存率(progression?free survival,PFS、总生存率(overall survival,OS)以及中位无进展生存期(median progression?free survival,mPFS)和中位总生存期(median overall survival,mOS)。结果HGG术后病人外周血CD4^+CD25^+细胞水平及CD4^+/CD8^+比值经同步放化疗后均有下降(P<0.05)。其余指标差异无统计学意义。中位随访时间14个月,范围为2~60个月,2例失访。1、2、3年全组病人PFS和OS分别为51.8%,38.3%,31.9%和71.3%,43.3%,37.2%。CD4^+/CD8^+≥1组病人mPFS及中位mOS均高于CD4^+/CD8^+<1组(16个月比9个月,P=0.004;36个月比11个月,P=0.031)。结论同步放化疗可降低HGG病人外周血CD4^+CD25^+细胞水平及CD4^+/CD8^+比值;放化疗前CD4^+/CD8^+比值可以作为评价HGG术后病人预后的有效指标,CD4^+/CD8^+比值低,预后差。Objective To explore the relationship between changes of lymphocyte subsets in patients with high grade glioma after concurrent chemoradiotherapy,and to analyze its influence on prognosis.Methods A total of 51 patients with postoperative high grade glioma who admitted to Anhui Provincial Cancer Hospital from June 2012 to July 2017 were choose as study objects.The changes of lymphocyte subgroups were detected before and after chemoradiotherapy.Based on CD4^+/CD8^+ratio before chemoradio?therapy,patients with high grade glioma were assigned into two groups:CD4^+/CD8^+≥1 and CD4^+/CD8^+<1.The progression free sur?vival(PFS),overall survival(OS),median progression?free survival(mPFS)and median overall survival(mOS)were calculated by the Kaplan?Meier method.Results The lever of CD4^+CD25^+and the ratio of CD4^+/CD8^+were decreased in patients with postop?erative high grade glioma after chemoradiotherapy(P<0.05).The difference of the other indicators was not statistically significant.The median follow?up time was 14 months(2?60 months),two patients were lost to follow?up.PFS rates in the 1?,2?,and 3?year were 51.8%,38.3%and 31.9%,respectively,and OS rates was 71.3%,43.3%and 37.2%,respectively.mPFS and mOS in CD4^+/CD8^+≥1 group were higher than those of CD4^+/CD8^+<1 group(16 months vs.9 months,P=0.004;36 months vs.11 months,P=0.031).Conclusions The lever of CD4^+CD25^+and the ratio of CD4^+/CD8^+were decreased in the HGG patients after chemoradio?therapy.The ratio of CD4^+/CD8^+before radiotherapy can be considered as an index to evaluate prognosis in patients with postopera?tive high grade glioma.The prognosis is poor in patients with low raito of CD4^+/CD8^+.

关 键 词：胶质瘤 CD4淋巴细胞计数 CD8阳性T淋巴细胞 CD4-CD8比值 白细胞介素2受体α亚单位 预后 

分 类 号：R73[医药卫生—肿瘤]