T淋巴细胞亚群评估晚期非小细胞肺癌放化疗后预后的价值  

The value of T lymphocyte subsets in evaluating the prognosis of advanced non-small cell lung cancer after radiotherapy and chemotherapy

作　　者：吴爱菊[1] 叶逢松[1] 叶鸿[1] 朱双媚 WU Ai-ju;YE Peng-song;YE Hong;ZHU Shuang-mei(Lishui People's Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]浙江省丽水市人民医院,浙江丽水323000

出　　处：《中国卫生检验杂志》2022年第12期1494-1498,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨T淋巴细胞亚群评估晚期非小细胞肺癌(NSCLC)放化疗后预后的价值。方法选择2017年1月-2019年12月198例初治晚期NSCLC患者,根据患者1年内预后情况将患者分为生存组86例和死亡组112例,比较2组患者一般资料、血清学指标,分析NSCLC放化疗后预后的影响因素和T淋巴细胞亚群预测NSCLC放化疗后预后的价值。结果2组KPS评分、转移器官数量、TNM分期、分化程度比较差异有统计学意义(P<0.05);死亡组患者白蛋白、淋巴细胞计数、CD4CD4^(+)/CD8^(+)低于生存组(P<0.05),白细胞计数、中性粒细胞计数、CD8高于生存组(P<0.05)。KPS评分、TNM分期、分化程度、CD4^(+)、CD8^(+),CD4^(+)/CD8^(+)是影响NSCLC放化疗后预后的主要因素(P<0.05)。CD4^(+),CD8^(+),CD4^(+)/CD8^(+)预测NSCLC放化疗后预后的AUC分别为0.681.0.6860.701。CD4^(+)<41.20%、CD8^(+)≥28.72%、CD4^(+)/CD8^(+)<1.41患者的生存期明显短于CD4^(+)≥41.20%、CD8^(+)<28.72%CD4^(+)/CD8^(+)<1.41患者(P<0.05)。结论T淋巴细胞亚群与晚期NSCLC放化疗后预后关系密切,可以作为预后评估的参考指标。Objective To investigate the value of T lymphocyte subsets in evaluating the prognosis of advanced non-small cell lung cancer(NSCLC) after radiotherapy and chemotherapy.Methods A total of 198 patients with advanced NSCLC who received radiotherapy and chemotherapy in our hospital from January 2017 to December 2019 were selected. General data and serological indicators before chemoradiotherapy were collected. The patients were divided into the survival group(n= 86) and the death group(n= 112) according to the 1-year prognosis, and the general data and serological indexes of the two groups were compared. The factors affecting the prognosis of NSCLC and the value of T lymphocyte subsets in predicting the prognosis was analyzed.Results There was statistical significance on the differences in KPS score, the number of metastatic organs,TNM stage and degree of differentiation between the two groups(P< 0. 05). The albumin, lymphocytecount, CD4^(+) and CD4^(+)/CD8^(+) in death group were significantly lower than those in survival group(P< 0. 05), while the WBC count, neutrophils and CD8^(+) were significantly higher than those in survival group(P< 0. 05). KPS score, TNM stage, differentiation degree, CD4^(+), CD8^(+) and CD4^(+)/CD8^(+) were the main factors affecting the prognosis of NSCLC after radiotherapy and chemotherapy(P< 0. 05). The AUC of CD4^(+), CD8^(+) and CD4^(+)/CD8^(+) in predicting the prognosis of NSCLC after radiotherapy and chemotherapy were 0. 681, 0. 686 and 0. 701, respectively. The survival time of patients with CD4^(+)< 41. 20%, CD8^(+)≥28. 72% and CD4^(+)/CD8^(+)< 1. 41 were significantly shorter than those with CD4^(+)≥41. 20%, CD8^(+)< 28. 72% and CD4^(+)/CD8^(+)< 1. 41(P< 0. 05).Conclusion T lymphocyte subsets are closely related to the prognosis of advanced NSCLC after radiotherapy and chemotherapy, and can be used as a reference index for prognosis evaluation.

关 键 词：肺癌 非小细胞肺癌 T淋巴细胞亚群 放疗 化疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]