| Background: Lung cancer is one of the most common and also the mostmalignant tumor in the world, accounting for14%of all malignant tumors. InChina, there are nearly50million new patients with lung cancer every year,non-small cell lung cancer accounts for80-85%among them.Nowadays,individualized and comprehensive treatments are advocated in thetreatment of lung cancer. Surgery,radiotherapy and chemotherapy,as the threecornerstones of the comprehensive cancer treatment,prolong the survival timeof patients with lung cancer, but the results are not satisfactory. The reportsindicated that the5-year survival rate of lung cancer is less than15%in U.S,while it is only10%in China. In recent years, with the continuallydevelopment of tumor immunology and molecular biology, more and moreresearch shows that the occurrence, development, transfer and recurrence ofmalignant tumors, is related to the body’s immunocompromised, especially thecellular immune function inhibition. Radiotherapy and chemotherapy is themost common means of cancer therapy, but chemotherapy drugs and ray canrecognize of tumor cells specificly, as a result,while playing a killing effecton tumor cells, they also killing the normal lymphocyte. Lymphocytes are themain immune cells of the body, lymphopenia reduce the body’s anti-tumorimmune function. T lymphocytes as the body of the most importantparticipants of the immune response, the distribution and function of theirsubsets has also been a research focus of the medical profession. CD4~+CD25~+Treg cells is a subtype of T lymphocytes, a number of studies have confirmedthat Treg cells play an extremely important role in maintain the stability ofthe internal environment, tumor immune surveillance, and prevention ofautoimmune diseases as well as induction of organ transplant tolerance.Another study also found that Treg cells play an important role intumor immune tolerance and immune suppression. Therefore, the clinicalsignificance of T lymphocyte subsets and Treg cells in cancer therapy worthfurther study.Objective: This study detecting T lymphocyte subsets and CD4~+CD25~+Treg cell ratio in peripheral blood of patients with non-small cell lung cancerby flow cytometry,before and afer radiotherapy or chemotherapy,observed therelationship between T lymphocyte subsets,CD4~+CD25~+Treg cells andprognosis of NSCLC,and further explore its clinical significance.Methods:154cases of NSCLC were collected from July2011to December2012inthe oncology department of Hebei general hospital.These patients werediagnosed by biopsying.There were39male and15female,age36-79years,mean age of62.8±9.22years,median age of64.2years;25cases ofsquamous cell carcinoma,and adenocarcinoma in29cases;5cases ofwell-differentiated,24cases of moderate differentiated,25cases of poorlydifferentiated;lung cancer TNM classification according to the2009NewInternational Study of Lung Cancer (IASLC):2cases ofⅠstage,9cases of Ⅱstage,27cases of Ⅲ stage,16cases of Ⅳ stage;25patients of radiotherapygroup,29cases of chemoradiotherapy and radiotherapy group.Collect20healthy examination people in the People’s Hospital of Hebei Province ascontrols,12males,8females,age29-76years,mean age57.8±12.0years,amedian age of60.4years.2Fasting peripheral venous blood3ml of the extracted lung cancerpatients,before radiotherapy and the next morning after the end ofradiotherapy.3Testing T lymphocyte subsets distribution and Treg cells in the ratio ofCD4~+T cells with flow cytometry.4Evaluate the therapy effects of all patients enrollde.5Analyze the data with SPSS16.0.According statistical data of differentrespectively by means of t test, Spearman rank correlation analysis and Kaplan -Meier survival analysis, P<0.05with statistical difference.Results:1Comparison of T lymphocyte subsets and Treg in peripheral bloodbetween non-small cell lung cancer patients and healthy control group:CD~+T, CD4~+T, of CD4~+T/CD8~+T in peripheral blood of patients withnon-small cell lung cancer were significantly lower than the healthy controlgroup, while CD8~+T was significantly higher than it in healthy control group,and the difference was statistically significant.(P <0.05)Treg in peripheral blood of patients with non-small cell lung cancer (8.62±2.16)%was significantly higher than it in healthy control group (2.18±1.36)%, and the difference was statistically significant.(P <0.01)2The relationship of T lymphocyte subsets and Treg and clinicalcharacteristics in patients with non-small cell lung cancer:The distribution of T lymphocyte subsets and Treg levels is unrelated topatients’ gender, age and tumor pathological type; related to pathological stage.CD3~+T, CD4~+T and CD4~+T/CD8~+T in patients of I-II stages were higher thanwhich in patients of III-IV stages;and CD8~+T, Treg was significantly lowerthan the patients of III-IV stages, the difference was statistically significant.3The change of T lymphocyte subsets and Treg in patients with non-small cell lung cancer before and after treatment and its impact on survival:Comparison of T lymphocyte subsets and Treg in peripheral blood ofnon-small cell lung cancer patients between before treatment and aftertreatment:Results of patients with radiotherapy: after radiotherapy CD3~+T, CD4~+T,CD4~+T/CD8~+T and Treg decreased than before, CD8~+T slightly higher thanbefore, but the difference was not statistically significance.Results of patients with radiotherapy and chemotherapy: after therapyCD3~+T、CD4~+T、CD4~+T/CD8~+T, Treg significantly decreased than before, andCD8~+T was higher than before, and the difference was statisticallysignificance.CD3~+, CD4~+T, of CD4~+T/CD8~+T and Treg in Patients received radiotherapy combined with chemotherapy decreased more significantly, CD8~+T increasedmore significantly, but the difference was not statistically significant.Treatment response rate (CR~+PR) increased in patients receivedradiotherapy combined with chemotherapy,survival period slightly extended,but the difference was not statistically significant.Treg in peripheral blood of non-small cell lung cancer patients wasnegatively correlated with survival; the difference was statistically significant.Conclusion:1CD3~+T cells, CD4~+T cells, CD4~+T/CD8~+T in peripheral blood of patientswith non-small cell lung cancer were significantly lower than the healthycontrol group, and CD8~+T was significantly higher than it in healthy controlgroup, and the difference was statistically significant.Treg cells in peripheralblood of patients with non-small cell lung cancer was significantly increasedcompared with the healthy control group,the later of the stage,this ratioincreases more, the difference was statistically significant.2Concurrent chemoradiotherapy can improve the response rate of lungcancer patients, but the long-term survival rate has not improved significantly.Considering it maybe related to concurrent chemoradiotherapy aggravateimmunosuppression in patients. At the same time of treatment,pay attention tostrengthening the immune system may help to achieve long-term survival withtumors. |
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