论文部分内容阅读
目的:探讨幼稚和记忆T细胞在非小细胞肺癌(non-small cell lung cancer,NSCLC)放疗患者外周血中的表达及其与预后的关系。方法:采用流式细胞仪检测2014年9月至2016年5月解放军307医院40例接受放疗的NSCLC首诊患者,治疗前外周血中幼稚CD4~+T细胞、记忆CD4~+T细胞、幼稚CD8~+T细胞、记忆CD8~+T细胞,与14例健康人进行对比,并分析其与临床病理特征及预后的关系。结果:与健康组相比,NSCLC患者幼稚CD4~+T细胞下降(P=0.031),记忆CD4~+T细胞和记忆CD8~+T细胞升高(P=0.014、0.005)。与不吸烟患者相比,吸烟患者幼稚CD4~+T细胞较低(P=0.043),记忆CD4~+T细胞较高(P=0.024)。与ECOG评分1~2分者相比,0分者幼稚CD8~+T细胞较低(P=0.017),记忆CD8~+T细胞较高(P=0.020)。单因素分析显示幼稚CD4~+T细胞较高组放疗后中位无进展生存期(median progression free survival,mPFS)更长(17个月vs.9个月,P=0.044)、记忆CD4~+T细胞较高组放疗后m PFS可能更短(9个月vs.15个月,P=0.069)。Cox多因素分析显示幼稚CD4~+T细胞与患者放疗后无进展生存期(progression free survival,PFS)独立相关(P=0.009)。结论:NSCLC患者外周血中幼稚T细胞储备下降,记忆T细胞上升。幼稚CD4~+T细胞较高可能预示放疗后PFS更长。
Objective: To investigate the expression of naive and memory T cells in peripheral blood of patients with non-small cell lung cancer (NSCLC) radiotherapy and its relationship with prognosis. Methods: Flow cytometry was used to detect the first diagnosis of 40 NSCLC patients receiving radiotherapy at the 307 Hospital of PLA from September 2014 to May 2016. The naive CD4 ~ + T cells and CD4 ~ + T cells in peripheral blood were pre-treated CD8 ~ + T cells, memory CD8 ~ + T cells, compared with 14 healthy people, and analyzed its relationship with clinicopathological features and prognosis. Results: Compared with the healthy group, the naive CD4 ~ + T cells decreased (P = 0.031), the memory CD4 ~ + T cells and the memory CD8 ~ + T cells increased in NSCLC patients (P = 0.014,0.005). Compared with non-smokers, naive CD4 ~ + T cells in smokers were lower (P = 0.043) and memory CD4 ~ + T cells were higher (P = 0.024). The scores of naive CD8 + T cells were lower (P = 0.017) and higher in memory CD8 + T cells (P = 0.020) than those with ECOG score of 1-2. Univariate analysis showed that median progression free survival (mPFS) was longer in the naive CD4 ~ + T cells after radiotherapy (17 months vs. 9 months, P = 0.044), CD4 ~ + M PFS may be shorter after radiotherapy in the higher T cells (9 months versus 15 months, P = 0.069). Cox multivariate analysis showed that naive CD4 ~ + T cells were independently associated with progression free survival (PFS) after radiotherapy (P = 0.009). Conclusion: The reserve of naive T cells in peripheral blood of NSCLC patients decreased and the number of memory T cells increased. The naive CD4 ~ + T cells may indicate higher PFS after radiotherapy.