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目的探讨多西他赛化疗前、化疗2周期评价疗效时复发转移性乳腺癌(MBC)患者外周血淋巴细胞亚群比率的变化及影响因素。方法应用流式细胞仪检测34例行多西他赛一线化疗的复发MBC患者化疗前、化疗2周期评价疗效时外周血淋巴细胞亚群[CD3~+T淋巴细胞、CD3~+/CD4~+T淋巴细胞、CD3~+/CD8~+T淋巴细胞、CD3-/CD16~+56~+自然杀伤细胞(NK)、CD3~+/CD16~+56~+T淋巴细胞、CD19~+B淋巴细胞、CD4~+/CD25~+调节性T细胞(Treg细胞)、CD8~+/CD28-T淋巴细胞和CD8~+/CD28~+T淋巴细胞]比率,并进一步分析患者临床病理因素对于外周血淋巴细胞亚群变化的影响。结果 34例患者化疗后CD3~+总T淋巴细胞、CD3~+/CD4~+T淋巴细胞及CD19~+B淋巴细胞比率均较化疗前下降(P=0.002、0.044、0.006),下降平均比率分别为2.2%、4.7%、3.1%。中位年龄﹥54岁的患者CD19~+B淋巴细胞下降比率较中位年龄≤54岁的患者小(P=0.031);中位OS﹥3.6个月的患者CD3~+总T淋巴细胞下降比率较中位OS≤33.6个月的患者小(P=0.038)。结论多西他赛化疗后MBC患者外周血总T、B淋巴细胞比率下降,免疫功能降低,而相对保留较好的T淋巴细胞免疫功能的患者可能有更好的生存获益。
Objective To investigate the changes of peripheral blood lymphocyte subsets in patients with recurrent metastatic breast cancer (MBC) before and after chemotherapy with docetaxel and its influencing factors. Methods Flow Cytometry (FCM) was used to detect the expression of CD3 + T lymphocytes, CD3 + / CD4 + T lymphocytes in 34 patients with recurrent MBC treated with first-line chemotherapy of docetaxel before chemotherapy and 2 cycles of chemotherapy. T lymphocytes, CD3 ~ + / CD8 ~ + T lymphocytes, CD3 ~ / CD16 ~ + 56 ~ + NK cells, CD3 ~ + / CD16 ~ + 56 ~ CD4 ~ + / CD25 ~ + regulatory T cells (Treg cells), CD8 ~ + / CD28-T lymphocytes and CD8 ~ + / CD28 ~ + T lymphocytes] ratio and further analysis of the clinical and pathological factors in patients with peripheral The Influence of Blood Lymphocyte Subsets Changes. Results The percentages of CD3 ~ + T lymphocytes, CD3 ~ + / CD4 ~ + T lymphocytes and CD19 ~ + B lymphocytes in 34 patients after chemotherapy were lower than those before chemotherapy (P = 0.002,0.044,0.006) Respectively, 2.2%, 4.7%, 3.1%. Patients with a median age of 54 years had a lower rate of CD19 ~ + B lymphocyte descent than those with a median age of 54 years (P = 0.031); patients with a median OS> 3.6 months had a decreased rate of CD3 ~ + T-lymphocyte depletion Patients who had a median OS ≤33.6 months were smaller (P = 0.038). Conclusion After chemotherapy with docetaxel, the ratio of total T and B lymphocytes in peripheral blood of patients with MBC is decreased and the immune function is decreased. Patients with relatively better retained T lymphocyte immune function may have better survival benefit.