Hu Jing, Zheng Lu, Zhang Huanle, Zhang Sandian, Xu Guodong
Department of Radiotherapy, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, Zhejiang Province, China.
Department of Cardiothoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, Zhejiang Province, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 May 25;46(5):523-528. doi: 10.3785/j.issn.1008-9292.2017.10.12.
To investigate the expression and prognostic value of memory T lymphocyte in patients with non-small cell lung cancer(NSCLC) following radiotherapy.
Forty-six patients with NSCLC receiving radiotherapy in Ningbo Medical Center Lihuili Hospital from February 2010 to May 2012 were enrolled in the study and 50 healthy subjects served as the control group. The central memory T cell (T) and effector memory T cell (T) in peripheral blood CD4, CD8 cells were detected by flow cytometry. Survival of patients was analyzed by Kaplan-Meier curve, and the relationship between clinical features, memory T lymphocyte changes and overall survival was analyzed by multivariate Cox regression model.
CD4T, CD4T, CD8T levels and CD4/CD8 T of NSCLC patients were significantly lower than those of the control group, while CD4/CD8 T was significantly higher than that of the control group(all <0.05). In NSCLC patients, CD4T, CD4T and CD8T were decreased and CD8T levels were increased 4 weeks after radiotherapy(all <0.05); CD4T, CD4T and CD8T at 12-week after radiotherapy were increased significantly compared with those at 4-week after radiotherapy(all <0.05). Multivariate Cox regression analysis showed that the change of CD4T after radiotherapy was correlated with the overall survival (95% :1.135-2.994, <0.01). The survival rate and overall survival time for patients with decreasing CD4 T were 23.1% and 10.7 months (95% :0.29-12.41), while those of patients with stable CD4 T were 52.7% and 27.4 months (95% :0.00-31.26), and those of patients with increasing CD4 T were 66.4% and 37.4 months (95% :0.33-29.21), respectively.
NSCLC patients show a significant immunosuppression at the initial stage after radiotherapy, and then a gradual improvement. Change of memory T lymphocyte after radiotherapy can be used to help predicting the prognosis of the patients.
探讨非小细胞肺癌(NSCLC)患者放疗后记忆性T淋巴细胞的表达及预后价值。
选取2010年2月至2012年5月在宁波市医疗中心李惠利医院接受放疗的46例NSCLC患者作为研究对象,另选50例健康受试者作为对照组。采用流式细胞术检测外周血CD4、CD8细胞中的中央记忆T细胞(T)和效应记忆T细胞(T)。采用Kaplan-Meier曲线分析患者的生存率,采用多因素Cox回归模型分析临床特征、记忆性T淋巴细胞变化与总生存的关系。
NSCLC患者的CD4T、CD4T、CD8T水平及CD4/CD8 T均显著低于对照组,而CD4/CD8 T显著高于对照组(均P<0.05)。NSCLC患者放疗后4周时,CD4T、CD4T及CD8T降低,CD8T水平升高(均P<0.05);放疗后12周时,CD4T、CD4T及CD8T较放疗后4周时显著升高(均P<0.05)。多因素Cox回归分析显示,放疗后CD4T的变化与总生存相关(95%CI:1.135-2.994,P<0.01)。CD4 T降低患者的生存率和总生存时间分别为23.1%和10.7个月(95%CI:0.29-12.41),CD4 T稳定患者分别为52.7%和27.4个月(95%CI:0.00-31.26),CD4 T升高患者分别为66.4%和37.4个月(95%CI:0.33-29.21)。
NSCLC患者放疗后初期存在明显免疫抑制,随后逐渐改善。放疗后记忆性T淋巴细胞的变化可用于帮助预测患者预后。