The Significance Of T Lymphocyte Subsets And CEA In Advanced Lung Adenocarcinoma Curative Effect Evaluation

Objective:More than half of lung cancer in hospital has been into stage IIIB/IV,theirmain treatment is chemotherapy, how to improve the sensitivity to evaluate thechemotherapy curtive of these patients, in order to choose the right treatment plan tosave the costing has become a major problem. Numerous studies have demonstratedcarcinoembryonic antigen(CEA) can be evaluated as an indicator of early diagnosis andtreatment of lung adenocarcinoma patients,but this single indicator to assess the efficacyis low sensitivity. In recent years, more and more evidence indicates that the occurrenceand development of lung cancer are closely related to the immune function, Tlymphocytes as the main course of anti-tumor effector cells involved in the body. Thisstudy detected T lymphocyte subsets(CD3+、CD4+、CD8+T lymphocyte cells andCD4+/CD8+ratio) and carcinoembryonic antigen(CEA) expression level in advancedlung adenocarcinoma patients before and after chemotherapy in the peripheral blood, todiscuss and analyze the singnificance of these various indicators in advanced lungadenocarcinoma patients chemotherapy curative effect evaluation, which may provid anew reference for lung adenocarcinoma patients to assess the efficacy of chemotherapy.Methods:To collect42patients in our hospital diagnosed as stage IIIB/IV lungadenocarcinoma patients from January2012to December2013. In the case of thepatients informed and agreed to accept three cycles of chemotherapy with docetaxelplus cisplatin. According to Response Evaluation Criteria in Solid Tumors, evaluatingthe condition of advanced lung adenocarcinoma patients before the forth chemotherapy.Using flow cytometry instrument and electro-chemiluminescence immunoassay to detect T lymphocyte subsets percentage and carcinoembryonic antigen(CEA)expression level before the first and forth chemotherapy,and comparing them toanalyze the significance in the chemotherapy curative effect evaluation. While compareT lymphocyte subsets percentage and carcinoembryonic antigen(CEA) expression levelof advanced lung adenocarcinoma patients before chemotherapy with43healthy controlgroup.Results:The CEA expression level of the advanced lung adenocarcinoma before thefirst chemotherapy was32.15±9.28(ug/l),significantly higher than the healthy controlgroup（1.73±0.63ug/l）,CD3+、CD4+T lymphocyte ratios and CD4+/CD8+ratio were65.42±7.35（%）、31.53±9.46（%）、0.92±0.30, lower than the healthy controlgroup(70.81±5.44%、42.29±6.38%、1.57±0.43）,CD8+T lymphocyte ratio was37.29±6.25（%）and higher than the healthy control group(28.56±5.32%), P<0.05,thedifference was statistically significant. The CEA expression level of effectivechemotherapy group(PR+SD) after chemotherapy was significantly lower than beforetreatment, CD4+T lymphocytes cells、CD4+/CD8+ratio increased obviously, andCD8+T lymphocytes cells decreased, P<0.05， the difference was statisticallysignificant； the CEA expression level and T lymphocyte subsets of invalidchemotherapy group(PD) after chemotherapy is compared with before chemotherapyshowed no statistically significant.Conclusion:1、The CEA expression level of lung adenocarcinoma patients increased,their immune function is lower than normal, and measured CEA and T lymphocytesubsets may help the early diagnosis of lung adenocarcinoma.2、The changes of Tlymphocyte subsets and CEA were closely related with the chemotherapy curativeeffect of advanced lung adenocarcinoma patients. They can be used as reference forassessing the efficacy of chemotherapy, and were helpful to understand the changes inimmune function of lung cancer patients,at the same time to detect T lymphocytesubsets and CEA can improve the sensitivity of the chemotherapy curative effect evaluation.