免疫细胞及炎症因子对晚期肺癌一线化疗效果的预测价值  

Predictive Value of Immune Cells and Inflammatory Markers on the Efficacy of First-Line Chemotherapy in Advanced Lung Cancer

作　　者：卢超[1] 胡志清[1] 吴亚斌 LU Chao;HU Zhiqing;WU Yabin(Department of Laboratory,Luoyang Central Hospital,Henan Luoyang 471000)

机构地区：[1]洛阳市中心医院检验科,河南洛阳471000

出　　处：《医学临床研究》2024年第5期750-753,共4页Journal of Clinical Research

摘　　要：【目的】探讨T淋巴细胞亚群、肿瘤浸润T淋巴细胞(Tils)及炎症因子对晚期肺癌一线化疗效果的预测价值。【方法】检测98例首诊TNM分期为Ⅲ/Ⅳ期的非小细胞肺腺癌患者的血清白细胞介素1α(IL-1α)、IL-6、IL-17、γ-干扰素(INF-γ)水平及T淋巴细胞亚群CD4^(+)T、CD8^(+)T、调节性T细胞、CD57^(+)细胞、Granzyme B^(+)细胞、CD45RO^(+)细胞比例;所有患者均接受紫杉醇注射液+顺铂化疗,治疗4个周期后评定疗效,并据此分为有效组和无效组,分析化疗无效的影响因素及预测疗效的有效标志物。【结果】化疗后,98例患者中69例化疗有效,29例无效。无效组患者淋巴结转移占比及调节性T细胞、IL-1α表达水平均高于有效组(P<0.05),CD57^(+)细胞、CD45RO^(+)细胞比例均低于有效组(P<0.05)。多因素逐步Logistic回归分析结果显示,调节性T细胞、IL-1α水平高是肺癌患者化疗无效的危险因素(P<0.05),CD57^(+)细胞、CD45RO^(+)细胞比例高是保护因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,调节性T细胞、CD57^(+)细胞、CD45RO^(+)细胞、IL-1α水平预测化疗效果的灵敏度分别为82.76%、86.21%、89.66%、93.10%,四者联合的灵敏度、特异度和曲线下面积(AUC)分别为82.76%、97.10%、0.957。【结论】T淋巴细胞亚群、Tils及炎症因子水平与晚期肺癌治疗效果密切相关,其可作为预测疗效的敏感指标。【Objective】This study aims to explore the predictive value of T lymphocyte subsets,tumor-infiltrating lymphocytes(Tils),and inflammatory markers on the effectiveness of first-line chemotherapy in advanced lung cancer.【Methods】Serum levels of interleukin 1α(IL-1α),IL-6,IL-17,and interferon-gamma(INF-γ),as well as the proportions of T lymphocyte subsets including CD4^(+)T cells,CD8^(+)T cells,regulatory T cells,CD57^(+)cells,Granzyme B^(+)cells,and CD45RO^(+)cells were measured in 98 newly diagnosed patients with stageⅢ/Ⅳnon-small cell lung adenocarcinoma.All patients received a chemotherapy regimen of paclitaxel injection and cisplatin for four cycles.Treatment effectiveness was assessed post-treatment,and patients were categorized into the responsive and non-responsive groups.Factors influencing the non-responsiveness and potential biomarkers for predicting treatment outcomes were analyzed.【Results】Out of 98 patients,69 were responsive to chemotherapy,while 29 were non-responsive.Non-responsive patients had a higher proportion of lymph node metastasis,and higher levels of regulatory T cells and IL-1αexpression(P<0.05),while their proportions of CD57^(+)and CD45RO^(+)cells were lower than those in the responsive group(P<0.05).Multivariate stepwise logistic regression analysis indicated that high levels of regulatory T cells and IL-1αwere risk factors for ineffective chemotherapy response(P<0.05),whereas CD57^(+)and CD45RO^(+)cells were protective factors(P<0.05).Receiver operating characteristic(ROC)curve analysis showed sensitivities of 82.76%,86.21%,89.66%,and 93.10%for regulatory T cells,CD57^(+)cells,CD45RO^(+)cells,and IL-1αlevels,respectively.The combined sensitivity,specificity,and area under the curve(AUC)of regulatory T cells,CD57^(+)cells,CD45RO^(+)cells,and IL-1αlevels were 82.76%,97.10%,and 0.957,respectively.【Conclusion】T lymphocyte subsets,Tils,and inflammatory markers are closely related to the treatment outcomes of advanced lung cancer and can serve as sensitive indicator

关 键 词：肺肿瘤 T淋巴细胞亚群 炎症趋化因子类/血液 药物疗法 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]