替莫唑胺联合调强放疗治疗高级别脑胶质瘤前后淋巴细胞亚群的动态观察  

Dynamic observation on lymphocyte subsets before and after temozolomide combined with intensity modulated radiotherapy for high-grade glioma

作　　者：徐利本[1] 龙璐璐[1] 吴立广[1] 徐惠[1] XU Liben;LONG Lulu;WU Liguang;XU Hui(Department of Radiotherapy,People’s Hospital Affiliated to Jiangsu University,Jiangsu,Zhenjiang 212000,China)

机构地区：[1]江苏大学附属人民医院放疗科,江苏镇江212000

出　　处：《中国医药科学》2025年第6期101-104,共4页China Medicine And Pharmacy

基　　金：江苏省镇江市第一人民医院院级课题(YP2023010)。

摘　　要：目的 研究替莫唑胺联合调强放疗治疗高级别脑胶质瘤患者的淋巴细胞亚群动态变化,判断其临床意义。方法 回顾性分析2018年12月至2022年12月江苏大学附属人民医院放疗科行替莫唑胺联合调强放疗的高级别脑胶质瘤患者45例,为观察组。选取同期健康体检者30例为对照组。比较治疗前后、不同病理分级、有效组和无效组淋巴细胞亚群[CD3^(+)、CD4^(+)、CD8^(+)、自然杀伤(NK)细胞、调节性T细胞(Tregs)]的变化。结果 治疗前观察组NK细胞、CD3^(+)、CD4^(+)较对照组低,CD8^(+)、Tregs较对照组高,差异有统计学意义(P<0.05)。治疗后观察组NK细胞、CD3^(+)、CD4^(+)升高,但NK细胞、CD3^(+)、CD4^(+)仍低于对照组,CD8^(+)、Tregs降低且仍高于对照组,差异有统计学意义(P<0.05)。治疗前Ⅲ级患者NK细胞、CD4^(+)、CD3^(+)较Ⅳ级高,Ⅳ级患者Tregs、CD8^(+)较Ⅲ级高(P<0.05),治疗后患者NK细胞、CD4^(+)、CD3^(+)升高,Tregs、CD8^(+)降低,Ⅲ级与Ⅳ级比较差异有统计学意义(P<0.05)。治疗前有效组和无效组NK细胞、Tregs、CD8^(+)、CD4^(+)、CD3^(+)差异无统计学意义(P>0.05),治疗后有效组CD4^(+)、CD3^(+)较无效组更高,Tregs较无效组更低,差异有统计学意义(P<0.05),两组NK细胞、CD8^(+)比较,差异无统计学意义(P>0.05)。结论 脑胶质瘤患者免疫功能低下,不同分级T细胞亚群和NK细胞表达不同,T细胞亚群和NK细胞表达与治疗效果有关,替莫唑胺联合调强放疗一定程度改善患者免疫功能,通过动态监测淋巴细胞亚群水平能辅助诊断、预判疗效。Objective To study the dynamic changes on lymphocyte subsets in patients with high-grade glioma treated by temozolomide combined with intensity modulated radiotherapy,so as to judge its clinical significance.Methods Patients with high-grade glioma who received temozolomide combined with intensity modulated radiotherapy in the Department of Radiotherapy of People’s Hospital Affiliated to Jiangsu University from December 2018 to December 2022 were analyzed retrospectively,and served as the observation group(n=45).People undergoing health examination were served as the control group(n=30).The changes of lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),natural killer[NK]cells and regulatory T cells[Tregs])were compared before and after treatment.Results Before treatment,the observation group had lower levels of NK cells,CD3^(+),and CD4^(+)compared to the control group,while CD8^(+)and Tregs were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,the observation group showed an increase in NK cells,CD3^(+),and CD4^(+),although NK cells,CD3^(+),and CD4^(+)remained lower than those in the control group.Meanwhile,CD8^(+)and Tregs decreased but were still higher than those in the control group,with statistically significant differences(P<0.05).Before treatment,GradeⅢpatients had higher levels of NK cells,CD4^(+),and CD3^(+)compared to GradeⅣpatients,while GradeⅣpatients had higher levels of Tregs and CD8^(+)than GradeⅢpatients(P<0.05).After treatment,NK cells,CD4^(+),and CD3^(+)increased,while Tregs and CD8^(+)decreased,with statistically significant differences between GradeⅢand GradeⅣpatients(P<0.05).Before treatment,there were no statistically significant differences in NK cells,Tregs,CD8^(+),CD4^(+),or CD3^(+)between the effective and ineffective groups(P>0.05).After treatment,the effective group had higher levels of CD4^(+)and CD3^(+)compared to the ineffective group,while Tregs were lower in the effective group,with statistically significant differences(

关 键 词：替莫唑胺 调强放疗 脑胶质瘤 淋巴细胞亚群 

分 类 号：R739.41[医药卫生—肿瘤]