培美曲塞与顺铂联合吉非替尼治疗对非小细胞肺癌患者T细胞亚群及细胞因子的影响  

Effects of pemetrexed and cisplatin combined with gefitinib on T cell subsets and cytokines in patients with lung cancer

作　　者：王毅[1] 权琳[1] WANG Yi;QUAN Lin(Department of Respiration,Nanjing Chest Hospital,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京市胸科医院呼吸科

出　　处：《东南国防医药》2020年第1期43-47,共5页Military Medical Journal of Southeast China

摘　　要：目的探究培美曲塞与顺铂联合吉非替尼治疗非小细胞肺癌患者的效果,以及对T细胞亚群及细胞因子的影响。方法回顾性分析2017年1月至2018年12月南京市胸科医院收治的84例非小细胞肺癌患者临床资料,依据治疗方式的不同分为吉非替尼组、培美曲塞联合顺铂组以及三药联合组(给予培美曲塞与顺铂联合吉非替尼治疗),每组各28例。比较3组患者治疗前后的免疫功能(CD3+、CD4+、CD8+、CD4+/CD8+、CD4+/CD25+)、细胞因子水平[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)以及γ干扰素(IFN-γ)],以及治疗后的不良反应发生情况。结果三药联合组治疗后CD3+([65.1±9.0)%]、CD4+([36.3±7.2)%]以及CD4+/CD8+(1.9±0.5)水平分别与吉非替尼组([55.3±6.4)%、(26.5±9.1)%、(1.1±0.2)]、培美曲塞联合顺铂组([57.8±6.9)%、(27.2±9.4)%、(1.2±0.3)]比较显著升高(P<0.05),3组患者的CD8+、NK以及CD4+/CD25+水平比较差异无统计学意义(P>0.05);三药联合组治疗后的IL-2([5.6±2.6)pg/mL]、TNF-α([6.1±2.9)pg/mL]以及IFN-γ([13.2±3.5)pg/mL]水平分别与吉非替尼组([3.3±2.3)pg/mL、(4.6±2.4)pg/mL、(9.5±2.8)pg/mL]、培美曲塞联合顺铂组([3.5±2.4)pg/mL、(4.9±2.6)pg/mL、(10.2±3.0)pg/mL]比较显著升高(P<0.05),IL-6([13.2±8.1)pg/mL]及IL-10([5.1±3.2)pg/mL]水平与吉非替尼组([18.2±6.9)pg/mL、(6.2±3.5)pg/mL]、培美曲塞联合顺铂组([17.3±7.0)pg/mL、(6.5±3.8)pg/mL]比较显著降低(P<0.05);三药联合组不良反应的总发生率(21.4%)显著低于吉非替尼组(57.1%)和培美曲塞联合顺铂组(42.9%),差异有统计学意义(P<0.05)。结论对非小细胞肺癌患者采用培美曲塞与顺铂联合吉非替尼治疗,有助于改善患者的T细胞亚群以及细胞因子的水平,不良反应较少,可帮助患者改善其症状。Objective To explore the effect of pemetrexed combined with cisplatin and gefitinib in the treatment of nonsmall cell lung cancer(NSCLC),and the effect on T cell subsets and cytokines.Methods The clinical data of 84 patients with nonsmall cell lung cancer received from January 2017 to December 2018 were retrospectively analyzed.According to the different treat⁃ment methods,they were divided into study group,gefitinib group and pemetrexed combined with cisplatin group,with 28 patients in each group.The control group was treated with gefitinib alone,while the control group was treated with pemetrexed combined with cisplatin.The study group was treated with pemetrexed plus cisplatin combined with gefitinib. The immune function,cytokine levels and the occurrence of toxic and side effects were compared be⁃tween the three groups before and after treatment. Results After treatment,the levels of CD3+[(65.1±9.0)%],CD4+[(36.3±7.2)%]and CD4+/CD8+(1.9±0.5)in the study group were significantly higher than those in the control group[(55.3±6.4)%,(26.5±9.1)%,(1.1±0.2)]and the control group[(57.8±6.9)%,(27.2±9.4)%,(1.2±0.3)],respectively(P<0.05). There was no significantdifference in the levels of CD8+,NK,CD4+/CD25+(P>0.05)between the three groups. After treatment,the levels of IL-2[(5.6±2.6)pg/mL],TNF-alpha[(6.1±2.9)pg/mL]and IFN-γ[(13.2±3.5)pg/mL]in the study group were significantly higher than those in thecontrol group[(3.3±2.3)pg/mL,(4.6±2.4)pg/mL,(9.5±2.8)pg/mL],the control group[(3.5±2.4)pg/mL,(4.9±2.6)pg/mL,(10.2±3.0)pg/mL],respectively. The levels of IL-6[(13.2±8.1)pg/mL]and IL-10[(5.1±3.2)pg/mL]were significantly lower in controlgroup[(18.2±6.9)pg/mL,(6.2±3.5)pg/mL]and control group[(17.3±7.0)pg/mL,(6.5±3.8)pg/mL](P<0.05). The total incidence oftoxic and side effects in the study group(21.4%)was significantly lower than that in the control group(57.1%)and the control group(42.9%)(P<0.05). Conclusion Pemetrexed combined with cisplatin and gefitinib in the treatment of non-small cell lung canc

关 键 词：培美曲塞 顺铂 吉非替尼 非小细胞肺癌 T细胞亚群 细胞因子 

分 类 号：R734.2[医药卫生—肿瘤]