The Influence Of Cisplatin Chemotherapy For Advanced Non-small Cell Lung Cancer Patient With T Lymphocytes And VEGF

The technique of Flow cytomertry and Enzyme linked immunosorbentassay were used to detect the expressions level of VEGF in peripheralblood of20healthy person and the number of T lymphocytes inperipheral blood of patients before and after chemotherapy in40patientswith Non-small cell lung cancer. The thesis discusses dynamic changes ofcellular immune function before and after chemotherapy in two kinds ofchemotherapy, and provides a theoretical basis for clinical chemotherapyin patients with the implementation of comprehensive treatment.The experimental results show that:1. peripheral blood CD3+、CD4+、T cell percentage and ratio of CD4+/CD8+in non small cell lung cancerpatients before chemotherapy were significantly lower than that ofcontrol group, CD8+、CD4+CD25+T cells were higher than that ofhealthy controls (P <0.05), And associated with clinical stage. In the firstweek after chemotherapy, these two groups of patients were presentimmunosuppressive state, in patients with paclitaxel group peripheralblood CD3+、CD4+cell percentage and ratio of CD4+/CD8+graduallyincreased until third weeks after chemotherapy, CD8+、CD4+CD25+Tcells decreased and the level of VEGF was increased beforechemotherapy. After fifth weeks chemotherapy the level close to beforechemotherapy.in patients with gemcitabine group peripheral blood CD3+、CD4+T cell percentage and ratio of CD4+/CD8+was higher than beforechemotherapy, CD8+、CD4+CD25+T cells decreased. and third weeksafter chemotherapy, peripheral blood in patients with CD3+、CD4+、T cellpercentage and ratio of CD4+/CD8+significantly increased, even close tothe normal level, CD8+、CD4+CD25+T cells were rapidly decreased (P < 0.05). The first four weeks after chemotherapy, the two groups of patientsperipheral blood CD3+、CD4+T cell percentage and ratio of CD4+/CD8+was dropped, CD4+CD25+T cells increased, but compared with first weekafter chemotherapy the amplitude reduced. Five weeks afterchemotherapy, cellular immune level rise again with two groups ofpatients.2. Peripheral blood the level of VEGF in non small cell lungcancer patients before chemotherapy was significantly higher thanhealthy controls (P <0.05), and associated with clinical stage, in the firstweek after chemotherapy, the level of VEGF in peripheral bloodincreased. The level of VEGF in peripheral blood with patients graduallydecreased from the second week after chemotherapy. Compared withpaclitaxel group, the level of VEGF decreased more significantly ingemcitabine group.3. Evaluation of curative effect after2cycleschemotherapy,20cases of effective (complete remission11cases, partialresponse9cases) and17cases of invalid (advances7cases, stable10cases) in40cases of chemotherapy patients, effective ones from secondweeks after chemotherapy, peripheral blood CD3+、CD4+、CD8+T cellpercentage and ratio of CD4+/CD8+continue to rise and the number ofCD4+CD25+T cells decreased, there was significant difference. peripheralblood CD3+、CD4+、CD8+T cell percentage and ratio of CD4+/CD8+hadno significant change in Invalid cases.The results show that: With the increase of clinical staging of lungcancer patients, T cell immune function was further inhibited, can bedifferent degree to promote the functional recovery by chemotherapy, butfor the Invalid group chemotherapy the T cell immune function was notimproved, and even low continuously. From second week afterchemotherapy the immune function gradually recovered in gemcitabinegroup of effective cases, the third week restore the most obvious, allaround in the fourth week was decreased but will quickly rise or evenclose to or more than the normal group in fifth week, the level of VEGF in effective group continued to reduce, ineffective group rose. And thepaclitaxel group is immunosuppressive period in second week, the cellimmune function effectively rose after the third week chemotherapy, bythe fifth week it could be close to the level before chemotherapy. Therewere no significant different changes with VEGF level between group ofgemcitabine and paclitaxel. Seems to gemcitabine combined cisplatinchemotherapy can obviously improve cellular immune function in a shortperiod of time after chemotherapy, the improvement in long time.Conclusion: dynamic monitoring of changes in T cells immune functionalstate after chemotherapy and its relevant factors to the curative effectevaluation have important value in making comprehensive treatment.