Lung Cancer And Esophageal Cancer Patients Analysis Of Peripheral Blood Lymphocyte Subsets Change

Background: Lung cancer is the most common malignancy, accountingfor the first cause of death in cancer. Closely related to the occurrence,development, metastasis and prognosis of immune function and tumor immuneescape mechanisms of lung cancer. Current clinical efficacy of conventionalchemotherapy put low in patients with advanced lung cancer, side effects, cannot effectively improve the survival rate of patients. In recent years, for amolecule epidermal growth factor receptor EGFR (Epidermal Growth FactorReceptor) targeted therapy received widespread attention at home and abroadoncology community, and to have EGFR mutations in lung cancer patients,targeted drug therapy [such as tyrosine kinase inhibitor (TKI)] can effectivelyprolong the survival of patients. Therefore, the target molecule detection oftumor tissue EGFR mutations in lung cancer patients has become a necessaryprerequisite for personalized medicine. EGFR, including non-small cell lung cancer in a variety of malignancies, including both overexpression causeduncontrolled signaling not only involved in cell proliferation and differentiation,but also in tumor invasion, metastasis and angiogenesis process which isoverexpressed plays an important role, so as to promote tumorigenesis anddevelopment. Experts believe that with EGFR mutations in non-small cell lungcancer biological behavior, treatment strategies, and other aspects of clinicaloutcome is totally different from no EGFR mutations in lung cancer, it shouldbe independent from the current classification of lung cancer and become"EGFR mutations lung cancer." Tibaldi like that, the number of lymphocytesin peripheral blood also indicate the prognosis of lung cancer patients. Based onthe results of the previous stage: the staging of patients with esophageal cancerin peripheral blood lymphocyte subsets and the percentage change in the disease,progress is closely related to, and can monitor the treatment effect, indicatingthat the prognosis. Changes in lymphocyte counts and lymphocyte subsets indifferent can sensitively reflect the immune status of the body’s cells directly, totimely and accurately determine the efficacy of the treatment and prognosis andto take appropriate measures as soon as possible is important.Objective: Detection of EGFR mutations and EGFR unmutated groupgrouped around the peripheral blood of patients with advanced lung cancertreatment under different genetic background differences lymphocytes and NKcells, analyze the differences before and after treatment of immune status and to evaluate clinical immunology from the perspective of the effect of differenttreatment options for patients and peripheral blood lymphocyte subsets counts.Methods: Using mutation-specific amplification system (AmplificationRefractory MutationSystem, ARMS) detected116cases of non-small cell lungcancer (NSCLCs) epidermal growth factor receptor outside No.18-21(EGFR)gene mutations in exons, the subgroup of patients with lung cancer: EGFREGFR mutation group and unmutated groups, namely the wild-type group. Flowcytometry (FCM) to detect changes in the percentage of peripheral bloodlymphocyte subsets around116cases of lung cancer patients.Results: Lung cancer patients (including the group of56patients withEGFR mutation and wild-type group,60patients), regardless of pre-treatmentand post-treatment, EGFR gene mutations in each group and the wild-typegroup the percentage of lymphocyte subsets and NK cells, the difference was notstatistically significant; EGFR mutations in patients after treatment beforetreatment each lymphocyte subsets and NK cell percentage, CD19+wassignificantly lower, the difference was statistically significant, other indicatorswere not statistically significant; according to the different treatment optionswithin their group, chemotherapy first-line choice compared with patients thanthe combined surgery and concurrent chemoradiotherapy in patients, CD4+andCD4+/CD8+ratio was significantly lower, the difference was statisticallysignificant, the rest of the indicators were not statistically different. Wild-type lung cancer patients before treatment after treatment with various percentage oflymphocyte subsets and NK cells, CD4+CD19+accompanied by elevatedlower, the difference was statistically significant, other indicators were notstatistically significant; according to the different treatment options within theirgroup, line selection of patients compared to chemotherapy than the combinedsurgery and concurrent chemoradiotherapy in patients, CD8+increased withCD4+/CD8+ratio was significantly lower, the difference was statisticallysignificant, the rest of the indicators were not statistically different; first-linechemotherapy in selected patients EGFR mutation group and each group of wild-type and NK lymphocyte subsets indicators compared to the percentage ofcells, the indicators showed no significant difference; diagnosed after surgerywith postoperative adjuvant chemotherapy, EGFR gene mutation group withwild-type group compared to the respective percentage of lymphocyte subsetsand NK cells, the indicators showed no significant difference; treatmentoptions for patients with concurrent radiotherapy and surgery combined withchemotherapy, EGFR gene mutations in each group and the wild-type group thepercentage of lymphocyte subsets and NK cells compared, CD4+cell levelslower, the difference was statistically significant, other indexes were notstatistically different.Conclusion: Advanced lung adenocarcinoma and EGFR gene mutations inpatients with wild-type genome, immune function were significantly inhibited in the state, no difference was observed population immunity levels. Wild-typegenome patients than patients with EGFR mutation increased significantly afterthe CD4+, indicating that EGFR gene invasive strong, poor prognosis. Differentimmunological effects of different treatment options for these two groups,targeted therapy for patients with advanced lung cancer and other immunetherapy of patients with no effect on the differences, but the mere palliativechemotherapy and surgery combined with radiotherapy and chemotherapy, thedifference between the obvious. Background: Tumorigenesis is a multi-factor, multi-stage process.Between tumor cells and the immune system interact, decreased immunefunction, or can be caused by many factors suppress tumorigenesis, and tumorscan also produce immunosuppressive factors by the immune system to produceinhibition. More and more studies confirm that tumor occurrence, progression,metastasis and prognosis of the body’s immune system is closely related to theanalysis of tumor subsets in peripheral blood lymphocytes and NK cell activityevaluation has become an important indicator of immune status [1,2,3].Lymphocytes (lymphocyte) is a component of the immune response of the bodyplay an important function of cells, including T cells (Th, Ts, Tc), B cells andNK cells and other subclasses, namely the cell-mediated immunity of the guidebody, and humoral immunity to tumor cells or virus-infected cells and otherdirect killing effect of immunological function.Objective: Explore the different clinical stages of esophageal cancer,lymph node metastasis and without lymph node metastasis in patients before and after treatment between peripheral blood lymphocytes and NK cell percentagechanges, and to analyze its relationship with prognosis.Methods: For August2010-August2012Affiliated Tumor Hospital ofGuangxi Medical University, collected53cases of esophageal cancer inperipheral blood using flow cytometry in patients two days before treatment,after treatment, three days the percentage of peripheral blood lymphocytesubsets.Results: Esophageal cancer patients after treatment with pre-treatment,CD3+, CD4+cell levels increased, CD8+, NK cell levels lower, the differencewas statistically significant, CD19+cell level was no significant difference inchange; III~Ⅳ stage and stage Ⅰ~Ⅱ patients compared to pre-treatment CD3+and CD4+cell levels lower, the difference was statistically significant, theother indexes and indicators differences were not statistically significant aftertreatment; patients with lymph node metastasis and without lymph nodemetastasis compared to pre-treatment levels of NK higher, the difference wasstatistically significant, the other indexes and indicators differences were notstatistically significant after treatment; recurrence or metastasis compared withpatients without recurrence or metastasis, low pre-treatment CD4+cell levels,CD8+, NK, CD19+higher cellular level, the difference was statisticallysignificant, CD4+cell levels lower after treatment, CD8+, NK, CD19+celllevel higher, the difference was statistically significant, CD3+difference was not statistically significant.Conclusion: Peripheral blood lymphocyte subsets in patients withesophageal cancer and the percentage of NK cells can effectively monitor theimmune status of patients before and after treatment, and by the percentage ofCD3+and CD4+lymphocytes and NK cells change in understanding stagingand metastatic disease were observed percentage of CD4+cells decreased, withCD8+, NK, CD19+cell percentage increased extent, predict the risk ofrecurrence of the disease.