晚期非小细胞肺癌患者T淋巴细胞亚群与免疫治疗联合化疗的疗效关系  

Relationship between T lymphocyte subsets and immunotherapy combined with chemotherapy in patients with advanced non-small cell lung cancer

作　　者：刘沫然 肖铟 何欣 郑广 韩宇田 Liu Moran;Xiao Yin;He Xin;Zheng Guang;Han Yutian(Laboratory Center,the Third Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000,Heilongjiang,China;Department of Oncology,the Third Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000,Heilongjiang,China;Department of Proctology,the Third Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000,Heilongjiang,China)

机构地区：[1]齐齐哈尔医学院附属第三医院检验中心,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院附属第三医院肿瘤一科,黑龙江齐齐哈尔161000 [3]齐齐哈尔医学院附属第三医院肛肠科,黑龙江齐齐哈尔161000

出　　处：《实用检验医师杂志》2024年第2期129-132,共4页Chinese Journal of Clinical Pathologist

基　　金：黑龙江省齐齐哈尔市科技计划联合引导项目(LSFGG-2023011)。

摘　　要：目的 探讨晚期非小细胞肺癌患者T淋巴细胞亚群与免疫治疗联合化疗的疗效关系。方法 选择齐齐哈尔医学院附属第三医院2022年1月—2023年1月收治的60例晚期非小细胞肺癌患者作为研究对象,均给予免疫治疗联合化疗。根据治疗效果分为疗效良好组(症状完全缓解或部分缓解;22例)与疗效不佳组(病情稳定或进展;38例),比较治疗前后患者的CD3^(+)T、CD4^(+)T、CD8^(+)T细胞比例以及CD4/CD8比值;绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),分析晚期非小细胞肺癌患者T淋巴细胞亚群与免疫治疗联合化疗疗效的相关性。结果 晚期非小细胞肺癌患者治疗2个周期后,CD8^(+)T细胞比例显著低于治疗前[(35.96±6.48)%比(42.37±12.26)%,P<0.05];治疗4个周期后,CD4^(+)T细胞比例、CD4/CD8比值均显著高于治疗2个周期后,CD8^(+)T细胞比例显著低于治疗2个周期后[CD4^(+)T细胞比例:(50.74±5.68)%比(46.22±8.25)%;CD4/CD8:1.55±0.21比1.28±0.40;CD8^(+)T细胞比例:(32.66±5.98)%比(35.96±6.48)%;均P<0.05];治疗4个周期后,疗效良好患者的CD8^(+)T细胞比例显著低于疗效不佳患者,CD4/CD8比值显著高于疗效不佳患者[CD8^(+)T细胞比例:(33.26±4.12)%比(39.20±6.95)%;CD4/CD8:1.34±0.18比1.21±0.15;均P<0.05]。ROC曲线分析结果显示,治疗2个周期后,疗效良好患者的CD4^(+)T、CD8^(+)T、CD3^(+)T细胞比例以及CD4/CD8比值的AUC分别为0.430、0.260、0.610、0.590;治疗4个周期后,疗效良好患者的CD4^(+)T、CD8^(+)T、CD3^(+)T细胞比例以及CD4/CD8比值的AUC分别为0.350、0.020、0.480、0.880。结论 晚期非小细胞肺癌患者T淋巴细胞亚群中的CD4/CD8指标用于免疫治疗联合化疗的疗效评估中效果较好。Objective To investigate the relationship between T lymphocyte subsets and the efficacy of immunotherapy combined with chemotherapy in patients with advanced non-small cell lung cancer.Methods The 60 patients with advanced non-small cell lung cancer admitted to the Third Affiliated Hospital of Qiqihar Medical College from January 2022 to January 2023 were selected as research subjects,and all of them received immunotherapy combined with chemotherapy.According to the treatment effect,the patients were divided into good treatment group(with complete response or partial response;22 cases)and poor treatment group(stable and progressive;38 cases).The proportions of CD3^(+)T,CD4^(+)T,CD8^(+)T cells and CD4/CD8 ratio before and after treatment were compared.The receiver operator characteristic(ROC)curve was plotted and the area under ROC curve(AUC)was calculated to analyze the correlation between T lymphocyte subsets and the efficacy of immunotherapy combined with chemotherapy in patients with advanced non-small cell lung cancer.Results After two cycles of treatment,the proportion of CD8^(+)T cells was significantly lower than that before treatment[(35.96±6.48)%vs.(42.37±12.26)%,P<0.05].After four cycles of treatment,CD4^(+)T cell proportion and CD4/CD8 ratio were significantly higher than those after two cycles of treatment,and CD8^(+)T cell proportion was significantly lower than that after two cycles of treatment[CD4^(+)T cell proportion:(50.74±5.68)%vs.(46.22±8.25)%;CD4/CD8:1.55±0.21 vs.1.28±0.40;CD8^(+)T cell proportion:(32.66±5.98)%vs.(35.96±6.48)%;all P<0.05].After four cycles of treatment,CD8^(+)T cell proportion in patients with good efficacy was significantly lower than that in patients with poor efficacy,and CD4/CD8 ratio was significantly higher than that in patients with poor efficacy[CD8^(+)T cell proportion:(33.26±4.12)%vs.(39.20±6.95)%;CD4/CD8:1.34±0.18 vs.1.21±0.15;both P<0.05].ROC curve analysis showed that after two cycles of treatment,the AUC of the proportions of CD4^(+)T,CD8^(+)T,CD3^(+

关 键 词：非小细胞肺癌 晚期 免疫治疗 化疗 T淋巴细胞亚群 疗效 

分 类 号：R734.2[医药卫生—肿瘤]