Biotherapy Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Front Immunol. 2024 Feb 28;15:1316778. doi: 10.3389/fimmu.2024.1316778. eCollection 2024.
Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths worldwide. Lymphocytes are the primary executors of the immune system and play essential roles in tumorigenesis and development. We investigated the dynamic changes in peripheral blood lymphocyte subsets to predict the efficacy of chemotherapy or combination immunotherapy in NSCLC.
This retrospective study collected data from 81 patients with NSCLC who received treatments at the First Affiliated Hospital of Zhengzhou University from May 2021 to May 2023. Patients were divided into response and non-response groups, chemotherapy and combination immunotherapy groups, and first-line and multiline groups. We analyzed the absolute counts of each lymphocyte subset in the peripheral blood at baseline and after each treatment cycle. Within-group and between-group differences were analyzed using paired Wilcoxon signed-rank and Mann-Whitney U tests, respectively. The ability of lymphocyte subsets to predict treatment efficacy was analyzed using receiver operating characteristic curve and logistic regression.
The absolute counts of lymphocyte subsets in the response group significantly increased after the first cycle of chemotherapy or combination immunotherapy, whereas those in the non-response group showed persistent decreases. Ratios of lymphocyte subsets after the first treatment cycle to those at baseline were able to predict treatment efficacy early. Combination immunotherapy could increase lymphocyte counts compared to chemotherapy alone. In addition, patients with NSCLC receiving chemotherapy or combination immunotherapy for the first time mainly presented with elevated lymphocyte levels, whereas multiline patients showed continuous reductions.
Dynamic surveillance of lymphocyte subsets could reflect a more actual immune status and predict efficacy early. Combination immunotherapy protected lymphocyte levels from rapid decrease and patients undergoing multiline treatments were more prone to lymphopenia than those receiving first-line treatment. This study provides a reference for the early prediction of the efficacy of clinical tumor treatment for timely combination of immunotherapy or the improvement of immune status.
非小细胞肺癌（NSCLC）仍然是全球癌症相关死亡的主要原因。淋巴细胞是免疫系统的主要执行者，在肿瘤发生和发展中发挥着重要作用。我们研究了外周血淋巴细胞亚群的动态变化，以预测 NSCLC 患者化疗或联合免疫治疗的疗效。
本回顾性研究收集了 2021 年 5 月至 2023 年 5 月在郑州大学第一附属医院接受治疗的 81 例 NSCLC 患者的数据。患者分为有反应组和无反应组、化疗组和联合免疫治疗组、一线组和多线组。我们分析了基线和每个治疗周期后外周血中每个淋巴细胞亚群的绝对计数。使用配对 Wilcoxon 符号秩和检验和 Mann-Whitney U 检验分别分析组内和组间差异。使用受试者工作特征曲线和逻辑回归分析淋巴细胞亚群预测治疗效果的能力。
化疗或联合免疫治疗第一周期后，有反应组淋巴细胞亚群的绝对计数显著增加，而无反应组则持续下降。首次治疗后淋巴细胞亚群的比值与基线时的比值能够早期预测治疗效果。与单独化疗相比，联合免疫治疗能够增加淋巴细胞计数。此外，首次接受化疗或联合免疫治疗的 NSCLC 患者主要表现为淋巴细胞水平升高，而多线患者则持续下降。
动态监测淋巴细胞亚群可以反映更实际的免疫状态，并早期预测疗效。联合免疫治疗可防止淋巴细胞水平迅速下降，多线治疗患者比一线治疗患者更容易出现淋巴细胞减少症。本研究为临床肿瘤治疗疗效的早期预测提供了参考，以便及时联合免疫治疗或改善免疫状态。
