肺癌患者化疗前后Th1/Th2细胞因子免疫反应状态变化及对预后的影响  

Changes of Th1/Th2 Cytokine Immune Response Status Before and After Chemotherapy in Lung Cancer Patients and Its Effect on Prognosis

作　　者：韦安猛[1] 张伟华[1] 张春玲[1] 张德震 李向向 WEI Anmeng;ZHANG Weihua;ZHANG Chunling(Shangqiu First People's Hospital,Shangqiu,476100)

机构地区：[1]河南省商丘市第一人民医院,476100

出　　处：《实用癌症杂志》2022年第5期746-751,共6页The Practical Journal of Cancer

基　　金：2019年河南省医学科技攻关计划联合共建项目(编号:LHGJ20191500)。

摘　　要：目的探究肺癌患者化疗前后Th1/Th2细胞因子免疫反应状态变化及对预后的影响。方法选取晚期肺癌患者90例作为观察组,另选取同期健康体检者40例作为对照组。观察组均行培美曲塞联合顺铂化疗,检测对比两组化疗前后白介素4(IL-4)、IL-6、IL-10、干扰素γ(IFN-γ)水平。并根据疗效分为有效者、无效者,比较不同疗效患者化疗前后IL-4、IL-6、IL-10、IFN-γ水平,分析上述指标对疗效的预测价值,并进行生存分析。结果观察组化疗前、化疗2个周期后第4、15、21 d血清IL-4、IL-6、IL-10水平高于对照组,IFN-γ低于对照组,观察组化疗2个周期后第4、15、21 d血清IL-4、IL-6、IL-10水平低于化疗前,IFN-γ水平高于化疗前(P<0.05);化疗前有效者血清IL-4、IL-6、IL-10水平低于无效者,IFN-γ水平高于无效者(P<0.05);有效者化疗2个周期后第4、15、21 d血清IL-4、IL-6、IL-10水平低于化疗前及无效者,IFN-γ水平高于化疗前及无效者(P<0.05);Logistic回归分析,IL-4、IL-6、IL-10、IFN-γ水平与晚期肺腺癌患者化疗疗效显著相关(P<0.05);Pearson相关性分析,化疗前及化疗2个周期后第4、15、21 d血清IFN-γ水平与IL-4、IL-6、IL-10水平呈负相关(P<0.05);IL-4、IL-6、IL-10、IFN-γ预测疗效均具有较高AUC值,尤以联合预测最高;血清IL-4、IL-6、IL-10高表达者生存率低于低表达者,IFN-γ高表达者生存率高于低表达者(P<0.05)。结论晚期肺癌患者存在Th1/Th2细胞因子免疫反应状态紊乱,培美曲塞联合顺铂化疗对改善机体免疫平衡有效;IFN-γ、IL-4、IL-6、IL-10水平与化疗疗效显著相关,联合检测可提高疗效与预后价值,为个体化治疗提供参考。Objective To explore the changes of Th1/Th2 cytokine immune response status before and after chemotherapy in lung cancer patients and its effect on prognosis.Methods 90 patients with advanced lung cancer were selected as the observation group,and 40 healthy subjects were selected as the control group during the same period.The observation group was treated with pemetrexed combined with cisplatin chemotherapy,and the levels of interleukin 4(IL-4),IL-6,IL-10 and interferon gamma(IFN-γ)before and after chemotherapy were detected and compared between the 2 groups and the observation group.According to the curative effect,the patients were divided into effective and ineffective.The levels of IL-4,IL-6,IL-10,and IFN-γwere compared before and after chemotherapy in patients with different curative effects.Results Serum IL-4,IL-6,IL-10 in the observation group before chemotherapy and 4 days,15 days,and 21 days after 2 cycles of chemotherapy were higher than the control group,and IFN-γwas lower than the control group,the serum IL-4,IL-6,IL-10 of the observation group on the 4th,15th,and 21st days after 2 cycles of chemotherapy were lower than before chemotherapy,and IFN-γwas higher than before chemotherapy(P<0.05);the serum IL-4,IL-6 and IL-10 of those who were effective before chemotherapy were lower than those who were ineffective,and IFN-γwas higher than those who were ineffective(P<0.05);the effective subjects had lower serum IL-4,IL-6,IL-10 on the 4th,15th,and 21st days after 2 cycles of chemotherapy than those before and ineffective,and IFN-γwas higher than those before and ineffective(P<0.05);Logistic regression analysis showed that IL-4,IL-6,IL-10 and IFN-γwere significantly correlated with the efficacy of chemotherapy in patients with advanced lung adenocarcinoma(P<0.05);Pearson correlation analysis showed that serum IFN-γwas negatively correlated with IL-4,IL-6,IL-10 before chemotherapy and at 4 days,15 days,and 21 days after chemotherapy(P<0.05);IL-4,IL-6,IL-10,and IFN-γall had a high AUC value for pred

关 键 词：肺癌 化疗 TH1/TH2细胞因子 免疫反应状态 预后 

分 类 号：R734.2[医药卫生—肿瘤]