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目的探讨肺癌患者化疗前后免疫功能变化及和功能状态评分间的关系。方法60例初治肺癌患者化疗前、化疗两个周期后分别用流式细胞仪检测的外周血淋巴细胞免疫分型并与20例正常体检者作对照,同时对肺癌患者进行功能状态评分。结果肺癌患者化疗前CD3+、CD4+、NK细胞比例分别为(46.19±8.72)%、(20.57±5.80)%、(17.67±6.53)%,均低于正常对照组[分别是(59.76±6.92)%、(35.89±6.97)%、(21.51±4.64)%],差异有统计学意义(P<0.05),CD8+细胞比例为(28.51±8.21)%,高于正常对照组[(20.93±4.78)%],差异有统计学意义(P<0.05),CD19+细胞比例为(7.54±4.29)%,与正常组[(9.52±4.06)%]相比,差异无统计学意义(P>0.05)。一线两药含铂方案化疗两个周期后,肺癌患者外周血CD3+、CD4+、NK细胞比例分别为(57.96±8.33)%、(33.29±6.90)%、(21.48±5.78)%,较化疗前有增多趋势,差异有统计学意义(P<0.05),而CD8+细胞比例为(21.64±5.10)%,较化疗前减少,差异有统计学意义(P<0.05)。肺癌患者功能状态评分化疗前平均为1.48±0.60,化疗后平均为1.45±0.95,差异无统计学意义(P>0.05)。结论肺癌患者免疫功能较正常人普遍降低,化疗在短期内有可能使肺癌患者免疫水平得到一定程度恢复,检测肺癌患者外周血淋巴细胞免疫分型可作为疗效评估和全身功能状态评分的补充。
Objective To investigate the relationship between the changes of immune function and functional status scores in patients with lung cancer before and after chemotherapy. Methods Sixty patients with newly diagnosed lung cancer before chemotherapy and two cycles of chemotherapy were detected by flow cytometry of peripheral blood lymphocyte immunophenotype and with 20 normal subjects as control, and functional status score of patients with lung cancer. Results The proportions of CD3 +, CD4 + and NK cells in patients with lung cancer were (46.19 ± 8.72)%, (20.57 ± 5.80)% and (17.67 ± 6.53)%, respectively, which were lower than those in the normal control group [59.76 ± 6.92% , (35.89 ± 6.97)% and (21.51 ± 4.64)%, respectively. The difference was statistically significant (P <0.05), and the percentage of CD8 + cells was (28.51 ± 8.21)% higher than that of the normal control group (20.93 ± 4.78)% The difference was statistically significant (P <0.05). The percentage of CD19 + cells was (7.54 ± 4.29)%, which was not significantly different from that of the normal group (9.52 ± 4.06%) (P> 0.05). The ratio of CD3 +, CD4 + and NK cells in the peripheral blood of patients with lung cancer were (57.96 ± 8.33)%, (33.29 ± 6.90)% and (21.48 ± 5.78)%, respectively, (P <0.05), while the proportion of CD8 + cells was (21.64 ± 5.10)%, which was significantly lower than that before chemotherapy. The difference was statistically significant (P <0.05). The score of functional status of patients with lung cancer was 1.48 ± 0.60 before chemotherapy and 1.45 ± 0.95 after chemotherapy, the difference was not statistically significant (P> 0.05). Conclusion The immune function of patients with lung cancer is generally lower than that of normal people. Chemotherapy may restore the immunity of lung cancer patients to a certain degree in a short time. To detect the immunophenotype of peripheral blood lymphocytes in patients with lung cancer can be used as a supplement to assess efficacy and score of general functional status.