淋巴细胞亚群失衡在肺癌发病中的作用及与患者肿瘤组织分化程度、生存率的关系  

Role of imbalance of lymphocyte subsets in the pathogenesis of lung cancer and its relationship with tumor differentiation and survival rate of patients

作　　者：骆许静 孙桢 方晓瑞 申晓燕 马耀先 Luo Xujing;Sun Zhen;Fang Xiaorui;Shen Xiaoyan;Ma Yaoxian(Department of Oncology,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]河南省许昌市中心医院肿瘤内科,461000

出　　处：《临床医学》2024年第10期8-12,共5页Clinical Medicine

基　　金：河南省卫生健康委员会项目(LHGJ20210944)。

摘　　要：目的探讨淋巴细胞亚群失衡在肺癌发病中的作用及与患者肿瘤组织分化程度、生存率的关系。方法选取2019年1月至2021年1月许昌市中心医院收治的88例肺癌患者作为肺癌组,另选取同一时间80例在许昌市中心医院的健康体检者作为健康组,采用流式细胞术检测所有研究对象的外周血淋巴细胞亚群水平。分析T淋巴细胞亚群水平与肺癌患者的不同临床分期、分化程度及病理类型的关系。肺癌组患者进行为期1年的生存随访,比较预后不同患者淋巴细胞的亚群水平,并利用ROC曲线分析淋巴细胞的亚群预测肺癌患者维持1年化疗后在生存率方面的价值。结果肺癌组CD3^(+)、CD4^(+)及自然杀伤(NK)细胞水平较健康组明显偏低,而CD8^(+)水平则高于健康组(P<0.05);随着肺癌患者分化程度的升高,其外周血中的CD3^(+)、CD4^(+)及NK细胞水平呈明显升高趋势,CD8^(+)则相反(P<0.05)。不同病理类型肺癌患者外周血淋巴细胞亚群比例比较,差异有统计学意义(P<0.05)。Ⅲ~Ⅳ期组患者外周血中CD3^(+)、CD4^(+)及NK细胞比例均较Ⅰ~Ⅱ期组患者显著偏低(P<0.05),而CD8^(+)T细胞比例高于Ⅰ~Ⅱ期,差异有统计学意义(P<0.05)。Spearman等级分析结果显示,CD3^(+)、CD4^(+)及NK细胞水平均与肺癌分期呈负相关,与分化程度呈正相关,而CD8^(+)细胞水平与肺癌分期呈正相关,与分化程度呈负相关(P<0.05)。对患者进行为期1年的生存随访,88例肺癌患者中31例死亡,病死率为35.23%。死亡组CD3^(+)、CD4^(+)及NK细胞水平均较生存组显著偏低,而CD8^(+)较生存组显著偏高(P<0.05)。ROC曲线分析结果显示,CD3^(+)、CD4^(+)、CD8^(+)及NK细胞水平预测肺癌患者化疗后1年生存率的ROC AUC分别为0.838(0.721~0.955)、0.826(0.708~0.944)、0.708(0.554~0.862)和0.618(0.618~0.900),截断值依次为65.38%、31.19%、25.21%和18.36%。预测价值:CD3^(+)>CD4^(+)>CD8^(+)>NK。结论肺癌患者的免疫状态弱于�Objective To investigate the role of lymphocyte subsets imbalance in the pathogenesis of lung cancer and its relationship with tumor differentiation and survival rate.Methods Eighty-eight lung cancer patients admitted to Xuchang Central Hospital from January 2019 to January 2021 were selected as the lung cancer group,and another 80 health examinees from Xuchang Central Hospital at the same time were selected as the health group.The peripheral blood lymphocyte subsets of all subjects were detected by flow cytometry.The relationship between the levels of T lymphocyte subsets and different clinical stages,differentiation levels,and pathological types of lung cancer patients were analyzed.The patients in the lung cancer group were followed up for 1 year to compare the lymphocyte subsets of patients with different prognosis,and the ROC curve was used to analyze the value of lymphocyte subsets in predicting the survival rate of lung cancer patients after one year of chemotherapy.Results The levels of CD3^(+),CD4^(+),and NK cells in the lung cancer group were significantly lower than those in the healthy group,while the levels of CD8^(+)were higher than those in the healthy group(P<0.05).As the degree of differentiation in lung cancer patients increases,the levels of CD3^(+),CD4^(+),and NK cells in their peripheral blood show a significant upward trend,while CD8^(+)shows the opposite trend(P<0.05).There was significant difference in the proportion of peripheral blood lymphocyte subsets among the patients with different pathological types of lung cancer(P<0.05).The proportion of CD3^(+),CD4^(+),and NK cells in the peripheral blood of patients with stageⅢ-Ⅳgroup was significantly lower than those of patients with stageⅠ-Ⅱgroup(P<0.05),while the proportion of CD8^(+)T cells was higher than that of patients with stageⅠ-Ⅱ,with significant differences(P<0.05).The Spearman rank analysis results showed that the levels of CD3^(+),CD4^(+),and NK cells were negatively correlated with lung cancer stage and positively co

关 键 词：淋巴细胞亚群 肺癌 稳态失衡 老年患者 分化程度 病理特征 预后评估 

分 类 号：R734.2[医药卫生—肿瘤]