晚期肺腺癌患者一线化疗后T淋巴细胞亚群变化及临床意义

BACKGROUND AND OBJECTIVE: The immune function disorder relates closely to the occurrence, metastasis, and prognosis of cancer. T lymphocyte subsets take an important role in immune function. We identified the dynamic changes of the immune system by investigating the levels of T lymphocyte subsets in peripheral blood of lung cancer patients with advanced stage adenocarcinoma undergoing first line chemotherapy. The results aided the search for rational chemo-immunotherapy strategies in lung cancer treatment. METHODS: Samples from 49 patients with pathologically demonstrated advanced stage adenocarcinoma cell lung cancer were compared with those from 33 healthy donors. Subsequently, the patients were separately treated with Docetaxol-based or Pemetrexed-based therapy. Peripheral blood samples at different time points after therapy were analyzed by flowcytometry. The lymphocyte subsets of the total lymphocytes were compared. Independent sample t test was used for the quantitative data analysis. RESULTS: The percentage of CD3(+), CD3(+)CD4(+), CD4(+)CD25(+) cells of the lung cancer patients significantly varied from those of the healthy donors, the P values are 0.012, 0.034 and 0.006 separately. The CD3(+) and CD3(+)CD4(+) levels increased significantly on the 4(th) and 7(th)-10(th) day post-chemotherapy, which return to normal levels on the 21(th) day. The CD3(+) level increased significantly both in the treatment group on all time points, while the CD3(+), CD3(+)CD4(+), CD4(+)/CD8(+) levels significantly increased and the CD3(+)CD8(+), CD8(+)CD28(-) levels significantly decreased on the 4(th) day in Pemetrexed group. The CD3(+)CD4(+) levels increased significantly on the 4(th) and 7(th)-10(th) day and the CD3(+)CD8(+), CD8(+)CD28(-) levels decreased on the 4(th) day in partial response group. CONCLUSION: The immune function of advanced stage adenocarcinoma cell lung cancer patients was evidently suppressed, and was restored at the 4(th) day, followed by a reduction at the 21st day after chemotherapy. On the 4(th) day, Pemetrexed showed better effect on the immune system. The change of immune system post-chemotherapy could be related with the prognosis.