胸腔镜肺癌根治术对非小细胞肺癌患者外周血T淋巴细胞亚群的影响及临床意义  

Effect of thoracoscopic radical resection on peripheral blood T lymphocyte subsets in patients with non-small cell lung cancer and their clinical significance

作　　者：何锋[1] 王小英 刘宁[1] 陈新富[1] 陈树兴[1] 林铿强 HE Feng;WANG Xiaoying;LIU Ning;CHEN Xinfu;CHEN Shuxing;LIN Kengqiang(Department of Thoracic Surgery,Fuzhou Pulmonary Hospital,Affiliated Teaching Hospital of Fujian Medical University,Fuzhou 350007,China)

机构地区：[1]福建医科大学附属教学医院福州肺科医院胸外科,福州350007

出　　处：《中国免疫学杂志》2022年第6期725-730,共6页Chinese Journal of Immunology

基　　金：福州市科技计划项目(2020-WS-117);2019年福州市级重点专科项目(201912003)资助。

摘　　要：目的:探讨胸腔镜肺癌根治术对非小细胞肺癌(NSCLC)患者外周血T淋巴细胞亚群的影响及临床意义。方法:流式细胞术检测233例接受肺癌根治术的NSCLC患者术前、术后第1、3、5天外周血T淋巴细胞亚群情况,根据手术方式不同,分为胸腔镜组(196例)和观察组(传统开胸组37例),结合临床指标分析接受胸腔镜肺癌根治术患者术前、术后外周血T淋巴细胞亚群变化。结果:NSCLC患者肺癌根治术后T淋巴细胞水平较术前降低,传统开胸组T淋巴细胞水平较胸腔镜组显著降低(P<0.05)。NSCLC患者胸腔镜肺癌根治术前后T淋巴细胞水平呈先降后升动态变化,术后第1天降到最低,术后第5天CD3^(+)、CD4^(+)T淋巴细胞水平高于术前(P<0.05)。术前CD3^(+)T淋巴细胞水平与年龄相关,年龄≤65岁组水平高于年龄>65岁组(P<0.05),CD4^(+)T淋巴细胞水平与肿瘤浸润程度相关,浸润性肺癌组较原位癌、微浸润癌组表达水平升高(P<0.05)。肺叶切除术组、肿瘤>3 cm、病理分期晚期、浸润性肺癌患者组术后CD4^(+)T淋巴细胞水平显著升高(P<0.05)。手术前后男性CD8^(+)T淋巴细胞水平高于女性患者(P<0.05)。手术前后CD4^(+)/CD8^(+)增高与肿瘤浸润程度相关,浸润性肺癌组CD4^(+)/CD8^(+)高于原位癌、微浸润癌组(P<0.05)。结论:胸腔镜肺癌根治术有助于NSCLC患者术后细胞免疫功能恢复。Objective:To investigate effect of thoracoscopic radical resection on peripheral blood T lymphocyte subsets in patients with non-small cell lung cancer(NSCLC)and their clinical significance.Methods:Peripheral blood T lymphocyte subsets of 233 NSCLC patients undergoing radical resection were detected by flow cytometry before operation,1 d,3 d,5 d after operation,who were divided into thoracoscope group(196 cases)and observation group(37 cases in traditional thoracotomy group)according to different surgical methods.Clinical indexes were compared to analyze changes of peripheral blood T lymphocyte subsets in patients with thoracoscopic radical resection of lung cancer.Results:T lymphocyte level of NSCLC patients after radical resection was lower than that before operation,and level of T lymphocyte in traditional thoracotomy group was significantly lower than that in thoracoscopic group(P<0.05).T lymphocyte subsets levels were decreased first and then increased during thoracoscopic radical resection,which was decreased to the lowest level at 1 d after operation,and CD3^(+)and CD4^(+)T lymphocytes at 5 d after operation were higher than those before operation(P<0.05).Preoperative CD3^(+)T lymphocyte level was correlated with age,age≤65 years old group level was higher than that of age>65 years old group(P<0.05).CD4^(+)T lymphocytes level was correlated with degree of tumor invasion before operation,whose expression of invasive lung cancer group was higher than that of in situ cancer and microinvasive cancer group(P<0.05).CD4^(+)T lymphocytes was increased significantly in lobectomy,tumor>3 cm,late pathological stage and invasive lung cancer(P<0.05).CD8^(+)T lymphocytes level in male patients was higher than that in female patients during operation(P<0.05).CD4^(+)/CD8^(+)was correlated with degree of tumor invasion.CD4^(+)/CD8^(+)in invasive lung cancer group was higher than that in situ cancer and microinvasive cancer group(P<0.05).Conclusion:Thoracoscopic radical resection is helpful for recovery of cellular immune

关 键 词：非小细胞肺癌 胸腔镜 肺癌根治术 T淋巴细胞亚群 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]