外周血淋巴细胞亚群在非小细胞肺癌中的表达及意义

赵皓; 齐学远; 王俊斌; 张小凤; 陶露; 余晾

doi:10.16766/j.cnki.issn.1674-4152.003240

外周血淋巴细胞亚群在非小细胞肺癌中的表达及意义

doi: 10.16766/j.cnki.issn.1674-4152.003240

赵皓^1, ,,
齐学远²,
王俊斌³,
张小凤¹,
陶露¹,
余晾¹

1.
蚌埠医学院第一附属医院中心实验室，安徽蚌埠 233004
2.
蚌埠医学院第一附属医院呼吸内科
3.
蚌埠医学院第一附属医院肿瘤内科

基金项目:

安徽省重点研究与开发计划项目 202004j07020010

详细信息

通讯作者:
赵皓, E-mail：37593323@qq.com

中图分类号: R734.2R730.43
计量
- 文章访问数: 251
- HTML全文浏览量: 95
- PDF下载量: 20
- 被引次数: 0
出版历程
- 收稿日期: 2023-06-16
- 网络出版日期: 2024-01-13

Expression and significance of peripheral blood lymphocyte subsets in non-small cell lung cancer

1.
Central Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨不同病理类型及临床分期的非小细胞肺癌患者外周血中淋巴细胞亚群的动态变化及意义，对比非小细胞肺癌患者与健康人群的免疫状态。方法采用流式细胞术对蚌埠医学院第一附属医院2020年5月—2023年2月呼吸内科和肿瘤内科住院的非小细胞肺癌患者外周血淋巴细胞亚群进行检测，其中肺鳞状细胞癌55例、肺腺癌49例，另筛选同期健康体检中心25例健康成人作为对照。结果非小细胞肺癌组的CD3⁺细胞、CD4⁺细胞比例分别为(67.43±9.01)%、(37.34±9.15)%，CD4⁺/CD8⁺值为1.57±0.80，低于对照组，NK细胞比例为(21.22±8.06)%，相比对照组明显增高，差异有统计学意义(均P＜0.05)。肺鳞状细胞癌与肺腺癌相比，各组数据差异均无统计学意义。Ⅲ~Ⅳ期CD3⁺细胞、CD4⁺细胞比例分别为(66.33±9.52)%、(36.01±9.44)%，低于Ⅰ~Ⅱ期，NK细胞比例为(22.81±8.43)%，相比Ⅰ~Ⅱ期明显增高，差异有统计学意义(均P＜0.05)。结论在非小细胞肺癌的发生过程中患者免疫功能受到抑制，并且随着病情的进展这种抑制作用进一步加重，检测非小细胞肺癌患者外周血中T淋巴细胞亚群、B细胞和NK细胞的占比对了解机体免疫状况、评估病情及指导治疗具有一定的临床意义。
- 非小细胞肺癌 /
- 临床分期 /
- 淋巴细胞亚群 /
- 流式细胞术 /
- NK细胞
Abstract: Objective To investigate the dynamic changes and significance of lymphocyte subsets in peripheral blood of non-small cell lung cancer (NSCLC) patients with different pathological types and clinical stages, and to compare the immune status of non-small cell lung cancer patients with healthy people. Methods Peripheral blood lymphocyte subsets of non-small cell lung cancer patients admitted to the Respiratory and Oncology Departments of the First Affiliated Hospital of Bengbu Medical College from May 2020 to February 2023 were detected by flow cytometry, including 55 cases of lung squamous cell carcinoma and 49 cases of lung adenocarcinoma, and 25 healthy adults from the health examination center during the same period were screened as controls. Results Compared with the control group, the proportions of CD3⁺ cells and CD4⁺ cells in NSCLC group were (67.43±9.01) % and (37.34±9.15) %, the ratio of CD4⁺/CD8⁺ was 1.57±0.80, which were lower than that in the control group; The proportion of NK cells was (21.22±8.06) %, which was significantly higher than that of the control group; The differences were statistically significant (all P < 0.05). There was no significant difference between squamous cell carcinoma and adenocarcinoma. In Ⅲ - Ⅳ period, the proportion of CD3⁺ cells and CD4⁺ cells were (66.33±9.52) % and (36.01±9.44) %, below Ⅰ - Ⅱ period; The proportion of NK cells was (22.81±8.43) %, which was significantly higher than that in stage Ⅰ- Ⅱ; The differences were statistically significant (all P < 0.05). Conclusion During the occurrence of NSCLC, the immune function of patients is inhibited, and this inhibition is further aggravated with the progression of the disease. It has certain clinical significance to detect the proportion of T lymphocyte subsets, B cells and NK cells in peripheral blood of NSCLC patients to understand the immune status of the body, evaluate the disease and guide the treatment.
- Non-small cell lung cancer /
- Clinical stages /
- Lymphocytes subsets /
- Flow cytometry /
- NK cell

HTML全文

表 1 NSCLC组与健康对照组一般资料比较

Table 1. Comparison of general data between NSCLC group and healthy control group

组别	例数	性别(例)		年龄(x±s，岁)
组别	例数	男性	女性	年龄(x±s，岁)
健康对照组	25	14	11	59.84±9.33
NSCLC组	104	62	42	61.54±8.54
统计量		0.109^a		0.420^b
P值		0.741		0.382
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 2 不同病理类型NSCLC患者一般资料比较

Table 2. Comparison of general data of NSCLC patients with different pathological types

组别	例数	性别(例)		年龄(x±s，岁)
组别	例数	男性	女性	年龄(x±s，岁)
鳞癌	55	31	24	60.55±7.86
腺癌	49	31	18	62.65±9.21
统计量		0.513^a		0.964^b
P值		0.474		0.211
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 3 不同临床分期NSCLC患者一般资料比较

Table 3. Comparison of general data of NSCLC patients with different clinical stages

组别	例数	性别(例)		年龄(x±s，岁)
组别	例数	男性	女性	年龄(x±s，岁)
Ⅰ~Ⅱ期	33	20	13	61.30±9.61
Ⅲ~Ⅳ期	71	42	29	61.65±8.07
统计量		0.020^a		1.189^b
P值		0.888		0.849
注：^a为χ²值，^b为t值。

下载: 导出CSV

表 4 NSCLC组与对照组淋巴细胞亚群水平比较(x±s)

Table 4. Comparison of lymphocytes subsets between NSCLC group and control group (x±s)

组别	例数	CD3⁺(%)	CD4⁺(%)	CD8⁺(%)	CD4⁺/CD8⁺	CD19⁺(%)	NK(%)
健康对照组	25	71.74±3.76	44.02±5.33	25.95±5.23	1.80±0.55	9.72±3.29	17.16±4.05
NSCLC组	104	67.43±9.01	37.34±9.15	27.29±8.45	1.57±0.80	9.42±6.58	21.22±8.06
t值		2.341	3.500	0.758	2.312	0.219	2.436
P值		0.021	0.001	0.450	0.024	0.827	0.016

下载: 导出CSV

表 5 不同病理类型肺癌患者淋巴细胞亚群水平比较(x±s)

Table 5. Comparison of lymphocyte subsets in patients with different pathological types of lung cancer (x±s)

病理类型	例数	CD3⁺(%)	CD4⁺(%)	CD8⁺(%)	CD4⁺/CD8⁺	CD19⁺(%)	NK(%)
鳞癌	55	66.83±8.74	37.63±8.38	26.26±8.03	1.64±0.82	10.06±7.54	21.73±8.12
腺癌	49	68.10±9.34	37.02±10.02	28.45±8.84	1.49±0.77	8.71±5.27	20.64±8.04
t值		0.711	0.333	1.320	0.933	1.044	0.685
P值		0.479	0.740	0.190	0.353	0.299	0.495

下载: 导出CSV

表 6 不同临床分期肺癌患者淋巴细胞亚群水平比较(x±s)

Table 6. Comparison of lymphocyte subsets in patients with different clinical stages of lung cancer (x±s)

临床分期	例数	CD3⁺(%)	CD4⁺(%)	CD8⁺(%)	CD4⁺/CD8⁺	CD19⁺(%)	NK(%)
Ⅰ~Ⅱ期	33	69.79±6.86	40.20±7.89	27.24±7.49	1.63±0.81	9.38±4.78	17.79±6.01
Ⅲ~Ⅳ期	71	66.33±9.52	36.01±9.44	27.32±8.92	1.54±0.79	9.44±7.29	22.81±8.43
t值		1.985	2.215	0.042	0.871	0.040	3.071
P值		0.029	0.021	0.967	0.386	0.968	0.003

下载: 导出CSV

参考文献(18)

[1]	蒋一玲, 张传领, 陈承, 等. 贝伐珠单抗联合靶向治疗对EGFR突变型非小细胞肺癌患者的疗效观察[J]. 中华全科医学, 2021, 19(8): 1306-1309. doi: 10.16766/j.cnki.issn.1674-4152.002047 JIANG Y L, ZHANG C L, CHEN C, et al. Observation of curative effect of bevacizumab combined with targeted treatment of EGFR mutant lung cancer[J]. Chinese Journal of General Practice, 2021, 19(8): 1306-1309. doi: 10.16766/j.cnki.issn.1674-4152.002047
[2]	何丽杰, 冯贺强, 褚相南, 等. DC-CIK生物治疗后肺癌患者Pro-GRP和T淋巴细胞亚群对免疫功能评价的临床意义[J]. 中国现代医学杂志, 2018, 28(19): 55-61. doi: 10.3969/j.issn.1005-8982.2018.19.011 HE L J, FENG H Q, CHU X N, et al. Value of Pro-GRP and T lymphocyte subsets in assessment of immune functions of lung cancer patients after DC-CI biological therapy[J]. China Journal of Modern Medicine, 2018, 28(19): 55-61. doi: 10.3969/j.issn.1005-8982.2018.19.011
[3]	ZHANG C T, LU Z M, HUANG H Y. The difference and relationship of CD4⁺ and CD8⁺ tumour infiltrating lymphocytes in lung adenocarcinoma[J]. Oncotarget, 2019, 10(13): 1271-1278. doi: 10.18632/oncotarget.26666
[4]	KATHRYN J G, JULIE E G. Adaptive immunity, chronic inflammation and the clock[J]. Semin Immunopathol, 2022, 44(2): 209-224. doi: 10.1007/s00281-022-00919-7
[5]	贡鸣, 何天宇, 裘敬平, 等. 6种常见肿瘤患者初治时外周血T淋巴细胞亚群数量及临床特征[J]. 中国医科大学学报, 2018, 47(12): 1119-1122. doi: 10.12007/j.issn.0258-4646.2018.12.015 GONG M, HE T Y, QIU J P, et al. Peripheral blood T-lymphocyte subsets in patients with six kinds of cancer and their clinical characteristics during the initial treatment[J]. Journal of China Medical University, 2018, 47(12): 1119-1122. doi: 10.12007/j.issn.0258-4646.2018.12.015
[6]	BARCELLOS-HOFF M H, GULLEY J L. Molecular pathways and mechanisms of TGF-β in cancer therapy[J]. Clin Cancer Res, 2023, 29(11): 2025-2033. doi: 10.1158/1078-0432.CCR-21-3750
[7]	李淑勤, 赵树强, 郑丽琴, 等. MicroRNA-425-5p通过靶向Fas信号通路调控肺癌A549细胞增殖、凋亡和转移的机制研究[J]. 中国免疫学杂志, 2022, 38(4): 437-442. LI S Q, ZHAO S Q, ZHENG L Q, et al. MicroRNA-425-5p regulates proliferation, apoptosis and metastasis of lung cancer A549 cells by targeting Fas-related signaling pathways[J]. Chinese Journal of Immunology, 2022, 38(4): 437-442.
[8]	CHEN T T, CHEN H X, LU W, et al. T lymphocyte subsets and PD-1 expression on lymphocytes in peripheral blood of patients with non-small cell lung cancer[J]. Medicine, 2022, 101(42): e31307. doi: 10.1097/MD.0000000000031307
[9]	王琛. 免疫学前沿与转化研究[J]. 药学进展, 2022, 46(8): 561-563. WANG S. Frontier and translational research in immunology[J]. Progress in Pharmaceutical Sciences, 2022, 46(8): 561-563.
[10]	喻敏, 康晶, 陈志未, 等. NK细胞的生物学特性及其在B细胞淋巴瘤应用中的研究进展[J]. 中国实验血液学杂志, 2020, 28(5): 1782-1786. YU M, KANG J, CHEN Z W, et al. Research progress on biological properties of natural killer cells and their application in B cell lymphoma[J]. Journal of Experimental Hematology, 2020, 28(5): 1782-1786.
[11]	王春霞, 辛丽亚, 张桂红, 等. 肺癌患者化疗前后外周血T淋巴细胞亚群及NK细胞的变化[J]. 中华肿瘤防治杂志, 2018, 6(25): 48-49. WANG C X, XIN L Y, ZHANG G H, et al. Variation of blood T lymphocyte subsets and NK cells before and after chemotherapy of the lung cancer in patients with peripheral[J]. Chinese Journal of Cancer Prevention and Treatment, 2018, 6(25): 48-49.
[12]	李爱杰, 刘超, 贺科文, 等. 非小细胞肺癌患者外周血淋巴细胞亚群水平检测临床意义[J]. 中华肿瘤防治杂志, 2020, 27(9): 740-744. LI A J, LIU C, HE K W, et al. Expression of peripheral lymphocytes subsets and its clinical significance in patients with non-small cell lung cancer[J]. Chinese Journal of Cancer Prevention and Treatment, 2020, 27(9): 740-744.
[13]	王健, 蒋国军, 戴婷, 等. 外周血淋巴细胞亚群和NK细胞在鉴别良恶性肺磨玻璃结节中的意义[J]. 南京医科大学学报, 2019, 39(8): 1217-1219. WANG J, JIANG G J, DAI T, et al. Significance of peripheral blood lymphocyte subsets and NK cells in differentiating benign and malignant pulmonary ground glass nodules[J]. Journal of Nanjing Medical University, 2019, 39(8): 1217-1219.
[14]	PENDE D, FALCO M, VITALE M, et al. Killer Ig-like receptors (KIRs): their role in NK cell modulation and developments leading to their clinical exploitation[J]. Front Immunol, 2019, 28(10): 1179.
[15]	高斌成. 非小细胞肺癌外周血CD3⁺、CD4⁺等T淋巴细胞亚群水平及意义[J]. 临床肺科杂志, 2018, 23(1): 138-141. GAO B C. Expression and significance of CD3⁺, CD4⁺ T lymphocyte subsets in patients with non-small cell lung cancer[J]. Journal of Clinical Pulmonary Medicine, 2018, 23(1): 138-141.
[16]	牛越, 石晓宇. 外周血淋巴细胞亚群检测在肺癌患者临床评估及辅助治疗中的意义[J]. 实用癌症杂志, 2019, 34(5): 785-787. NIU Y, SHI X Y. Significance of detection of peripheral bloodlymphocyte subsets in clinical evaluation and adjuvant treatment of patients with lung cancer[J]. The Practical Journal of Cancer, 2019, 34(5): 785-787.
[17]	张楠, 周晓燕, 卞涛. 外周血T淋巴细胞亚群检测在非小细胞肺癌中的临床意义[J]. 当代医学, 2020, 26(22): 80-82. ZHANG N, ZHOU X Y, BIAN T. Clinical significance of peripheral blood T-lymphocyte subsets determination in non-small cell lung cancer[J]. Contemporary Medicine, 2020, 26(22): 80-82.
[18]	SOPHIE S, ALI B D, PHILIPP L, et al. Elevated levels of circulating Hsp70 and an increased prevalence of CD94⁺/CD69⁺ NK cells is predictive for advanced stage non-small cell lung cancer[J]. Cancers, 2022, 14(22): 5701-5713.