双药联合化疗对不同体能状态广泛期小细胞肺癌患者T淋巴细胞亚群及预后的影响  

Effects of Dual-drug Combined Chemotherapy on T-lymphocyte Subsets and Prognosis of Patients with Extensive Small Cell Lung Cancer in Different Physical Status

作　　者：邱野[1] 江玉兰 张霞[1] 贾钰铭[1] QIU Ye;JIANG Yulan;ZHANG Xia(Yibin Second People's Hospital,Yibin,644000)

机构地区：[1]四川省宜宾市第二人民医院,644000 [2]川北医学院,637000

出　　处：《实用癌症杂志》2020年第3期410-413,共4页The Practical Journal of Cancer

摘　　要：目的探究依托泊苷联合铂类双药联合化疗对不同ECOG评分状态的广泛期小细胞肺癌患者T淋巴细胞亚群及预后的影响。方法筛选出符合研究条件的广泛期小细胞肺癌患者共96例,依据ECOG评分标准将其分为3组(PS=0组、PS=1组、PS=2组)。每组患者均给予依托泊苷联合铂类双药方案化疗4周期。开始治疗前1天与治疗结束后3周检测患者T淋巴细胞亚群CD3、CD4、CD8阳性率。治疗结束后,对3组患者进行6个月的随访,统计随访期间各组的死亡人数及死亡时间。结果相比于治疗前,体能状态差(PS=2)组患者治疗后的CD4、CD4/CD8均显著降低(P<0.05),而PS=1组患者和PS=0组患者治疗后的CD4、CD4/CD8变化不明显(P>0.05)。3组患者的CD3与CD8在治疗前后的变化均不显著(P>0.05)。疗效评估结果表明,相比于PS=1组与PS=0组患者,PS=2组患者的有效率与疾病控制率均显著降低,而治疗期间死亡率明显升高(P<0.05)。相比于PS=2组,PS=1组与PS=0组的6个月生存率更高(PS=1组:χ2=6.742,P=0.002;PS=0组:χ2=8.115,P<0.001),而PS=1组与PS=0组的6个月生存率无显著差异(χ2=1.106,P=0.208)。结论全身化疗可使体能状态差(PS=2)的广泛期小细胞肺癌患者免疫力降低,这可能是导致患者6个月生存率低的重要因素。Objective To investigate the effects of etoposide combined with platinum-based dual-drug chemotherapy on T lymphocyte subsets and prognosis in patients with extensive small cell lung cancer with different ECOG scores.Methods A total of 96 patients with extensive small cell lung cancer who met the study conditions were screened.Patients were divided into 3 groups according to the ECOG score(PS=0,PS=1,PS=2).Each group of patients was given etoposide combined with platinum-based dual-drug regimen for 4 cycles.The positive rates of CD3,CD4,and CD8 in the T lymphocyte subsets were measured 1 day before the start of treatment and 3 weeks after the end of treatment.After the end of treatment,the 3 groups of patients were followed up for 6 months,and the number of deaths and death time of each group during the follow-up period were counted.Results Compared with the pre-treatment,patients with poor physical status(PS=2)had significantly lower CD4 and CD4/CD8 after treatment(P<0.05).The changes of CD4 and CD4/CD8 in patients with PS=1 group and PS=0 group were not significant(P>0.05).The changes of CD3 and CD8 in the 3 groups were not significant(P>0.05).Efficacy evaluation showed that the effective rate and disease control rate of PS=2 group were significantly lower than those of PS=1 group and PS=0 group,and the mortality during treatment was significantly increased(P<0.05).Compared with PS=2 group,the 6-month survival rate of PS=1 group and PS=0 group was higher(PS=1 group:χ2=6.742,P=0.002;PS=0 group:χ2=8.115,P<0.001),and there was no significant difference in the 6-month survival rate between the PS=1 group and the PS=0 group(χ2=1.106,P=0.208).Conclusion Systemic chemotherapy can reduce the immunity of patients with extensive small cell lung cancer with PS=2,which may be an important factor in reducing the 6-month survival rate of patients.

关 键 词：依托泊苷 体能状态 广泛期小细胞肺癌 T淋巴细胞亚群 预后 

分 类 号：R734.2[医药卫生—肿瘤]