Luo Zhuanbo, Wang Yun, Lou Yanru, Cao Chao, Hubbard Richard, Xu Ning, Huang Xiaoping
1 Department of Respiratory Diseases, The Affiliated Ningbo No. 1 Hospital, School of Medicine, Ningbo University, Ningbo - PR China.
2 Department of Hematology, The Affiliated Ningbo No. 1 Hospital, School of Medicine, Ningbo University, Ningbo - PR China.
Int J Biol Markers. 2018 May;33(2):208-214. doi: 10.5301/ijbm.5000309. Epub 2017 Nov 15.
There is an unmet need for identification of additional prognostic markers for lung cancer. The aim of this study was to identify novel clinical and immunological predictors of prognosis in lung cancer patients.
Lymphocyte subsets CD3+, CD4+, CD8+, CD4+/8+, CD25+, CD69+, CD44+ and CD54+ were quantified in peripheral blood using flow cytometry, for 203 newly diagnosed lung cancer patients and 120 healthy controls.
The levels of CD3+, CD4+, CD8+, CD4+/CD8+ and CD69+ lymphocytes were significantly lower in patients with lung cancer compared with the healthy control group, while CD54+ and CD44+ lymphocytes were significantly higher. In stage III/IV patients with lymph node metastasis or distant metastasis, the levels of CD44+ and CD54+ lymphocytes were significantly increased compared with patients with stage I/II disease (p<0.05). The levels of CD44+ and CD54+ lymphocytes markedly reduced after chemotherapy, and follow-up analysis indicated that patients found without increase of CD44+ and CD54+ lymphocytes after chemotherapy had survival advantages. Independent predictors of survival in lung cancer patients included clinical stage (hazard ratio [HR] = 2.791; 95% confidence interval [95% CI], 1.42-3.54, p<0.001), CD44+ lymphocytes (HR = 1.282; 95% CI, 1.02-1.49, p = 0.002) and CD54+ lymphocytes (HR = 1.475; 95% CI, 1.22-1.73, p = 0.003). Elevated levels of CD44+ and CD54+ lymphocytes correlated with poor prognosis in lung cancer patients.
Peripheral blood lymphocyte subsets in patients with lung cancer are different from those in healthy people, and circulating CD44+ and CD54+ lymphocytes seem to be a promising criterion to predict survival in lung cancer patients undergoing chemotherapy.
肺癌仍需要鉴定更多的预后标志物。本研究旨在鉴定肺癌患者预后的新型临床和免疫预测指标。
采用流式细胞术对203例新诊断肺癌患者和120例健康对照者外周血中的淋巴细胞亚群CD3⁺、CD4⁺、CD8⁺、CD4⁺/8⁺、CD25⁺、CD69⁺、CD44⁺和CD54⁺进行定量分析。
与健康对照组相比，肺癌患者的CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺和CD69⁺淋巴细胞水平显著降低，而CD54⁺和CD44⁺淋巴细胞水平显著升高。在有淋巴结转移或远处转移的Ⅲ/Ⅳ期患者中，CD44⁺和CD54⁺淋巴细胞水平较Ⅰ/Ⅱ期患者显著升高（p<0.05）。化疗后CD44⁺和CD54⁺淋巴细胞水平明显降低，随访分析表明化疗后CD44⁺和CD54⁺淋巴细胞未升高的患者具有生存优势。肺癌患者生存的独立预测因素包括临床分期（风险比[HR]=2.791；95%置信区间[95%CI]，1.42 - 3.54，p<0.001）、CD44⁺淋巴细胞（HR = 1.282；95%CI，1.02 - 1.49，p = 0.002）和CD54⁺淋巴细胞（HR = 1.475；95%CI，1.22 - 1.73，p = 0.003）。CD44⁺和CD54⁺淋巴细胞水平升高与肺癌患者预后不良相关。
肺癌患者外周血淋巴细胞亚群与健康人不同，循环中的CD44⁺和CD54⁺淋巴细胞似乎是预测接受化疗的肺癌患者生存的一个有前景的指标。
