COPD合并肺癌的临床特征及肿瘤微环境相关研究  

Study the Clinical Characteristics and Tumor Microenvironment of Chronic Obstructive Pulmonary Disease Complicated with Lung Cancer

作　　者：朱少群[1] 陈光喜[2] 杜丹丹[3] 邓建华 刘志强[2] 张敏[2] ZHU Shaoqun;CHEN Guangxi;DU Dandan;DENG Jianhua;LIU Zhiqiang;ZHANG Min(Department of Radiology,Jiujiang NO.1 People's Hospital,Jiujiang 332000,China;不详)

机构地区：[1]九江市第一人民医院影像科,江西九江332000 [2]九江市第一人民医院全科医学科,江西九江332000 [3]九江市第一人民医院九龙社区卫生服务中心内科,江西九江332008 [4]九江市第一人民医院肿瘤内科,江西九江332000

出　　处：《中国医学创新》2024年第35期127-132,共6页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202311464)。

摘　　要：目的:探讨分析慢性阻塞性肺疾病(COPD)合并肺癌的临床特征及肿瘤微环境相关研究。方法:选取2023年1—8月九江市第一人民医院收治的40例COPD合并肺癌的患者纳入COPD合并肺癌组,选择同一时段入院的60例COPD患者纳入COPD组,30例肺癌患者纳入肺癌组。比较三组的临床表现、影像学特征、肺功能指标、炎症指标[白细胞介素-6(IL-6)]、微环境免疫细胞T细胞[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、B细胞、自然杀伤(NK)细胞]。结果:三组咯血、肺不张、肺气肿、胸腔积液发生率比较,差异均有统计学意义(P<0.05);COPD合并肺癌组咳嗽、咳痰、胸闷、咯血、肺气肿、胸腔积液发生率均高于肺癌组,COPD合并肺癌组咯血、肺不张、肺气肿、胸腔积液发生率均高于COPD组,差异均有统计学意义(P<0.05)。三组肺纹理改变、“毛刺”征、“分叶”征、肺叶透亮度改变发生率比较,差异均有统计学意义(P<0.05)。三组间肺功能指标水平比较,差异均无统计学意义(P>0.05)。三组IL-6水平比较,差异无统计学意义(P>0.05);三组T细胞、B细胞、NK细胞、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较,差异均有统计学意义(P<0.05);COPD合并肺癌组的T细胞、B细胞、NK细胞、CD4^(+)、CD4^(+)/CD8^(+)均低于肺癌组,CD8^(+)高于肺癌组,且NK细胞、CD4^(+)/CD8^(+)均低于COPD组,CD8^(+)高于COPD组,差异均有统计学意义(P<0.05);COPD组NK细胞、CD4^(+)/CD8^(+)均低于肺癌组,差异均有统计学意义(P<0.05)。结论:COPD合并肺癌与单纯COPD患者临床症状存在重叠性,COPD合并肺癌存在肿瘤免疫抑制微环境特征。Objective:To investigate the clinical characteristics of chronic obstructive pulmonary disease(COPD)complicated with lung cancer and the study of tumor microenvironment.Method:A total of 40 patients with COPD and lung cancer admitted to Jiujiang NO.1 People's Hospital from January to August 2023 were included in COPD complicated with lung cancer group,60 patients with COPD and 30 patients with lung cancer admitted at the same time were included in COPD group and lung cancer group.The clinical manifestations,imaging features,pulmonary function indicators,inflammatory indicators[interleukin-6(IL-6)],microenvironmental immune cells T cells[CD4^(+),CD8^(+),CD4^(+)/CD8^(+),B cells,natural killer(NK)cells]of the three groups were compared.Result:There were significant differences in the incidence of hemoptysis,atelectasis,emphysema and pleural effusion among the three groups(P<0.05).The incidence of cough,sputum,chest tightness,hemoptysis,emphysema and pleural effusion in COPD complicated with lung cancer group were higher than those in lung cancer group,and the incidence of hemoptysis,atelectasis,emphysema and pleural effusion in COPD complicated with lung cancer group were higher than those in COPD group,the differences were statistically significant(P<0.05).There were significant differences in the incidence of lung texture change,"burr"sign,"lobed"sign and changes in lung lobe transmittance among the three groups(P<0.05).There were no significant differences in the levels of lung function indexes among the three groups(P>0.05).There was no significant difference in IL-6 levels among the three groups(P>0.05).There were significant differences in T cells,B cells,NK cells,CD4^(+),^(+)CD8 and CD4^(+)/CD8^(+)among the three groups(P<0.05).T cells,B cells,NK cells,CD4^(+),CD4^(+)/CD8^(+)in COPD complicated with lung cancer group were lower than those in^(+)lung cancer group,CD8 was higher than that in lung cancer group,and NK cells,CD4^(+)/CD8^(+)were lower than those^(+)in COPD group,CD8 was higher than that in COPD gro

关 键 词：慢性阻塞性肺疾病 肺癌 临床特征 肿瘤微环境 

分 类 号：R734.2[医药卫生—肿瘤] R563.9[医药卫生—临床医学]