Dynamic Study Of T Cell Subsets And NK And Tumor Markers In Patients With Advanced Gastric Cancer Before And After Chemotherapy

ObjectiveWe completed this study for two parts to elucidate the state of immunity in patients with advanced gastric cancer before and after chemotherapy.One was dynamic detecting T-lymphocyte subsets and NK cells, another was CEA、CA19-9、CA72-4、molecular marker Ki-67 index, for going into chemotherapy in advanced gastric cancer cellular immune function, it is reasonable for the clinical treatment plan, determine the therapeutic effect and timely funding related to immunotherapy objective basis.Methods47 cases of experiment group before chemotherapy FOLFOX fasting one day and 21 days after the end of chemotherapy with two cycles.we collected peripheral blood by flow cytometry of T lymphocyte subgroup and NK cells; by chemiluminescence immunoassay of CEA, CA72-4, CA19-9 joint detection; by immunohistochemistry of Ki-67 expression before chemotherapy carcinoma. According to the efficacy of the packet, compared with a control group of 28 healthy people, data were analyzed between them.Results1. AGC on peripheral blood T lymphocyte subsets, NK cells Chemotherapy.(1)Experience group compared with control group, CD3+,CD4+ and the ratio of CD4+/CD8+and NK cells were significantly lower, CD8+ and the expression levels of Treg cell was significantly increased.(2) After chemotherapy CD3+, CD4+ and CD4+/CD8+ratio were significantly higher, decreased CD8+, Treg expression in patients in effective group.(3) After chemotherapy the expression levels of Treg cell significantly decreased in stable group after chemotherapy.(4)After chemotherapy the ratio of CD4+/CD8+ a further decline in ineffective group.2. AGC chemotherapy on tumor molecular markers.(1) Experience group CEA,CA72-4, CA19-9 before chemotherapy is higher than control group.(2)Before and after chemotherapy the positive rate of serum CEA was respective 72.3%(34/47)and42.6%(20/47).The positive rate of serum CA72-4 was respective 74.5%(35/47)and29.8%(14/47). The positive rate of serum CA19-9 was respective 63.8%(30/47) and31.9%(15/47). Combination of the three positive rates before and after chemotherapy was87.2%(41/47),55.3%(26/47).(3)After chemotherapy, the total response rate was42.6%(20/47), the cases of decreasing indexes were CEA70%(14/20),CA72-495%(19/20)、CA19-9 80%(5/27).The total nonresponse rate was57.4%(27/47),the cases of decreasing indexes were CEA18.51%(5/27),CA72-4 37.04%(10/27),CA19-929.63%(8/27). The positive rate of three indicators before and after chemotherapy were significantly different; compared with the positive rate of combined detection of single index improved significantly;(4) Those patients Ki-67-positive rate was 100%, higher expression rate was 82.98%(39/47),whose expression was significantly correlated with tumor grade, clinical stage and lymph node metastasis;(5)The positive rate of Ki-67 was no significant with the positive rate of CEA, CA72-4, CAl9-9.(6) The positive rate of Ki-67 was no significant with the effectiveness of chemotherapy, it could not be used to evaluate the efficacy of chemotherapy in patients with AGC.Conclusion1. The patients with AGC reduced immune function of T lymphocytes in immunosuppression. Chemotherapy can improve the immune status in some patients, of which belonged to effective Chemotherapy. 2 Dynamic determination of T lymphocyte subsets, NK cells can be observed as an important indicator of immune function in AGC patients with chemotherapy, and CEA, CA72-4, CA19-9 has a certain clinical evaluation of its chemotherapy value. 3. Molecular markers Ki-67 index was related to the progress of gastric cancer. However, the significance of the index to evaluate the clinical efficacy of chemotherapy remains to be further expanded.