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非小细胞肺癌患者外周血淋巴细胞亚群绝对计数变化的临床价值

The clinical value of the changes of peripheral lymphocyte subsets absolute counts in patients with non-small cell lung cancer.

作者信息

Xia Ying, Li Wentao, Li Yongmin, Liu Yunhe, Ye Songshan, Liu Aqing, Yu Jianchun, Jia Yingjie, Liu Xu, Chen Huayu, Guo Yongtie

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China; Tianjin University of Traditional Chinese Medicine, Graduate School, Tianjin, China.

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Oncology Department, Tianjin, China.

出版信息

Transl Oncol. 2020 Dec;13(12):100849. doi: 10.1016/j.tranon.2020.100849. Epub 2020 Aug 28.

Abstract

INTRODUCTION

Immune function strongly influences the outcome of patients with non-small cell lung cancer (NSCLC). It's vital to understand the immune state of patients through detecting the percentage and number of lymphocyte subsets accurately, and helpful to evaluate conditions of prognosis and adjust treatment for patients.

METHODS

We conducted a retrospective cohort study in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China. The absolute counts and percentages of CD3+, CD3 + CD4+, CD3 + CD8+, B and NK cells were determined by single platform technologies. 172 patients received treatment including surgery or chemotherapy after surgery. The factors affecting disease progression were analyzed by Binary Logistic regression. Progression free survival (PFS) calculating survivals were with the method of Kaplan-Meier. The log-rank test and cox's proportional hazard regression (enter method) were used for univariable and multivariable analyses respectively.

RESULTS

Relative to normal controls, patients with NSCLC at different stages showed decreased absolute lymphocyte count obviously, rather than lymphocyte percentages. Different treatments had unlike influence on the homeostasis of lymphocytes and the effects last for a long time. Logistic regression showed CD3 + CD4+ and CD3 + CD8+ could contribute to favorable prognosis. Multivariate analysis of prognostic factors of PFS showed CD3 + CD4+ cell was independent factor for predicting PFS.

CONCLUSIONS

The absolute count of CD3+, CD3 + CD4+, CD3 + CD8+, B and NK cells were better indication of the patient's immune state than percentages of each lymphocyte subsets. Immune function was impaired in patients with non-small cell lung. The high level of baseline absolute CD3 + CD4+ cells count contributed to longer progression free survival. Chinese Clinic Trial Registry number: ChiCTR-IOR-17014139; Registry date: 2017/12/25.

摘要

引言

免疫功能对非小细胞肺癌(NSCLC)患者的预后有重大影响。通过准确检测淋巴细胞亚群的百分比和数量来了解患者的免疫状态至关重要,这有助于评估患者的预后情况并调整治疗方案。

方法

我们在中国天津的天津中医药大学第一附属医院进行了一项回顾性队列研究。采用单平台技术测定CD3+、CD3+CD4+、CD3+CD8+、B细胞和NK细胞的绝对计数和百分比。172例患者接受了包括手术或术后化疗在内的治疗。采用二元Logistic回归分析影响疾病进展的因素。采用Kaplan-Meier法计算无进展生存期(PFS)。分别采用对数秩检验和Cox比例风险回归(逐步法)进行单因素和多因素分析。

结果

与正常对照组相比,不同分期的NSCLC患者淋巴细胞绝对计数明显降低,而非淋巴细胞百分比。不同治疗对淋巴细胞稳态有不同影响,且这种影响持续时间较长。Logistic回归显示CD3+CD4+和CD3+CD8+有助于良好预后。PFS预后因素的多因素分析显示CD3+CD4+细胞是预测PFS的独立因素。

结论

CD3+、CD3+CD4+、CD3+CD8+、B细胞和NK细胞的绝对计数比各淋巴细胞亚群的百分比更能反映患者的免疫状态。非小细胞肺癌患者免疫功能受损。基线CD3+CD4+细胞绝对计数较高有助于延长无进展生存期。中国临床试验注册号:ChiCTR-IOR-17014139;注册日期:2017年12月25日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2c9/7475266/771f5d72fdcd/gr1.jpg

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