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目的检测非小细胞肺癌(NSCLC)患者治疗前后外周血CD4+CD25+调节性T细胞(Treg)水平的变化,并研究其与癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片断(CYFRA21-1)、肿瘤特异性生长因子(TSGF)之间的相关性,探讨其在NSCLC病情监测及判断预后方面的临床应用价值。方法采用流式细胞技术检测59例NSCLC患者治疗前、治疗结束、治疗结束后3个月外周血CD4+CD25+Treg水平,并分别采用化学发光法、速率法检测CEA、NSE、CYFRA21-1、TSGF水平。结果治疗前、治疗结束、治疗结束后3个月CD4+CD25+Treg水平分别为(23.37±5.84)%、(19.42±4.03)%、(17.17±6.51)%,与CEA的相关系数分别为0.759、0.751、0.760;与CYFRA21-1的相关系数分别为0.760、0.679、0.750;与TSGF的相关系数分别为0.632、0.736、0.796(P<0.01),与NSE则无明显相关性。近期疗效评价为CR和PR的患者在治疗结束和结束后3个月CD4+CD25+Treg水平均较PD和SD患者低[(17.97±2.47)%vs.(22.47±4.97)%,P<0.01;(13.60±3.01)%vs.(24.68±5.40)%,P<0.01],治疗前水平则无显著差异[(23.79±7.67)%vs.(23.17±4.84)%,P=0.749]。结论 NSCLC患者外周血CD4+CD25+Treg水平随机体肿瘤负荷变化而变化,在NSCLC病情监测和判断预后方面具有一定的临床价值。
Objective To detect the changes of CD4 + CD25 + regulatory T cells (Treg) in peripheral blood of patients with non-small cell lung cancer (NSCLC) before and after treatment, and to study the relationship between CEA, NSE, Cytokeratin 19 (CYFRA21-1) and tumor-specific growth factor (TSGF) in patients with NSCLC, and to investigate its clinical value in the surveillance of NSCLC and prognosis. Methods Flow cytometry was used to detect the levels of CD4 + CD25 + Treg in peripheral blood of 59 patients with NSCLC before treatment, after treatment, 3 months after the end of treatment. The levels of CEA, NSE, CYFRA21-1, TSGF level. Results The levels of CD4 + CD25 + Treg at 3 month after treatment were (23.37 ± 5.84)%, (19.42 ± 4.03)% and (17.17 ± 6.51)%, respectively. The correlation coefficients with CEA were 0.759 , 0.751,0.760 respectively; the correlation coefficients with CYFRA21-1 were 0.760,0.679,0.750 respectively; the correlation coefficients with TSGF were 0.632,0.736,0.796 (P <0.01), but not with NSE. Patients with CR and PR in the short term had lower CD4 + CD25 + Treg levels at the end of treatment and 3 months after the end of treatment than those with PD and SD [(17.97 ± 2.47)% vs (22.47 ± 4.97)%, P <0.01 ; (13.60 ± 3.01)% vs (24.68 ± 5.40)%, P <0.01]. There was no significant difference before treatment (23.79 ± 7.67% vs 23.17 ± 4.84%, P = 0.749). Conclusion The level of CD4 + CD25 + Treg in peripheral blood of patients with NSCLC varies with the change of tumor burden. It has certain clinical value in monitoring the disease and prognosis of NSCLC.