外周血细胞因子和炎性细胞在肺癌患者中的表达变化及临床意义  

Expression changes and clinical significance of cytokines and inflammatory cells in peripheral blood of lung cancer patients

作　　者：石梦瑶 张娜娜[1] 王麟[1] 彭冲[1] 刘明军[1] 孙桂荣[1] SHI Mengyao;ZHANG Nana;WANG Lin;PENG Chong;LIU Mingjun;SUN Guirong(Department of Clinical Laboratory,the Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong,China)

机构地区：[1]青岛大学附属医院检验科,山东青岛266003

出　　处：《临床检验杂志》2022年第11期863-869,共7页Chinese Journal of Clinical Laboratory Science

摘　　要：目的探讨肺癌患者外周血12种细胞因子和3种炎性细胞及其比值的变化与临床意义。方法研究对象为2020年3月至2022年6月期间在青岛大学附属医院诊治的458例肺癌患者及44例健康查体人员,采用多重微球流式免疫荧光发光法检测外周血细胞因子水平,荧光流式细胞技术检测炎性细胞计数。统计学分析采用秩和检验。结果对照组、小细胞肺癌(SCLC)组和非小细胞肺癌(NSCLC)组3组间外周血白细胞介素(IL)-2、IL-5、IL-6、IL-8和肿瘤坏死因子(TNF)-α5种细胞因子水平差异存在统计学意义(P均<0.05)。与对照组相比,SCLC组和NSCLC组IL-6、IL-8、TNF-α水平均明显升高,同时NSCLC组IL-5水平明显升高而IL-2水平明显降低(P均<0.05);SCLC组IL-6水平较NSCLC组显著升高(P<0.01);肺鳞癌组IL-2、IL-6水平较肺腺癌组明显升高(P均<0.01)。对照组、SCLC组、NSCLC组3组间外周血中性粒细胞计数(ANC)、淋巴细胞计数(ALC)、单核细胞计数(AMC)、中性粒细胞计数与淋巴细胞计数比值(NLR)和单核细胞计数与淋巴细胞计数比值(MLR)水平差异有统计学意义(P均<0.001);SCLC组和NSCLC组ANC、AMC、NLR、MLR水平均明显高于对照组,ALC水平均明显低于对照组(P均<0.001);SCLC组NLR、MLR水平较NSCLC组明显升高,而ALC水平明显降低(P均<0.01);肺鳞癌组ANC、AMC、NLR、MLR水平明显高于肺腺癌组(P均<0.001)。随着TNM分期的升高,SCLC组IL-6水平和NSCLC组IL-5、IL-6、IL-8水平明显升高(P均<0.05)。同时,SCLC组NLR、MLR水平显著升高(P均<0.01),ALC水平明显降低(P<0.05),NSCLC组ANC、AMC、NLR、MLR水平显著升高(P均<0.01)。肺癌患者经4周期化疗后,疾病控制组IL-6、IL-8、TNF-α和ANC、ALC、NLR水平较治疗前明显降低(P均<0.05),疾病进展组IL-6、IL-8、TNF-α和ANC、AMC、NLR、MLR水平明显升高,而ALC水平明显降低(P均<0.05);同时经4周期化疗后,疾病进展组IL-6、IL-8、TNF-α、ANC、AMC、NLR和MLR水平明显高于疾�Objective To investigate the changes of the levels of 12 cytokines and 3 types of inflammatory cells as well as their ratios in peripheral blood,and their clinical significance in lung cancer patients.Methods A total of 458 lung cancer patients diagnosed in the affiliated hospital of Qingdao University from March 2020 to June 2022 were selected and 44 healthy individuals for physical examination were used as the controls.The levels of cytokines in peripheral blood were measured by multi-microsphere immunofluorescence assay and inflammatory cells counts were measured by fluorescence flow cytometry.The data were analyzed using rank sum test.Results Among the three groups,i.e.,control,small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC),statistic differences for the levels of interleukin(IL)-2,IL-5,IL-6,IL-8 and tumor necrosis factor(TNF)-αin peripheral blood were found(all P<0.05).Compared to control group,IL-6,IL-8 and TNF-αlevels in SCLC group and NSCLC groups were significantly increased.IL-5 level was increased,while IL-2 level was decreased in NSCLC group(all P<0.05).IL-6 level was increased in SCLC group compared to that in NSCLC group(P<0.01).IL-2 and IL-6 levels were increased in lung squamous cell carcinoma group compared to those in lung adenocarcinoma group(all P<0.01).The levels of absolute neutrophil count(ANC),absolute lymphocyte count(ALC),absolute monocyte count(AMC),neutrophil-to-lymphocyte ratio(NLR)and monocyte-to-lymphocyte ratio(MLR)in peripheral blood were statistically different among the three groups(all P<0.001).Compared to control group,ANC,AMC,NLR and MLR levels in both SCLC and NSCLC group were increased,and ALC level was decreased(all P<0.001).Increased NLR and MLR levels and decreased ALC level in SCLC group were observed compared to those in NSCLC group(all P<0.01).The levels of ANC,AMC,NLR and MLR were raised in lung squamous cell carcinoma group compared to those in lung adenocarcinoma group(all P<0.001).With the progress of TNM stage,the levels of IL-6 in SCLC group

关 键 词：肺癌 肿瘤微环境 细胞因子 炎性细胞 疗效 

分 类 号：R446.6[医药卫生—诊断学]