| Background and Purpose:The immune system plays a vital role in the occurrence,development and treatment of tumors.The traditional viewpoint is that chemotherapy has a certain killing effect on immune cells in addition to killing tumor cells.Chemotherapy reduces the immune function of tumor patients.However,in recent years,many studies have confirmed the enhancing effect of chemotherapy on body immunity.In addition,many studies confirm the predictive effect of some immune indexes on chemotherapy efficacy and overall survival time of tumor patients.however,there is few studies about the changes of lymphocyte subsets after chemotherapy for Small Cell Lung Cancer(SCLC)before,and there is no relevant study on the relationship between lymphocyte subsets and the chemotherapy efficacy of small cell lung cancer.This study conducted a retrospective analysis on the changes of lymphocyte subsets after chemotherapy for 95 cases of small cell lung cancer.To explore the effect of chemotherapy on the immune function of small cell lung cancer patients,and further explore whether there are differences in the expression of immune indexes in different stages,and the predictive effect of immune indexes on the short-term efficacy of chemotherapy.Methods:Patients with Small cell lung cancer who were referred to the Department of Oncology,the second hospital of Dalian medical unnivercity,from January 2013 to December 2018 were enrolled.All patients were confirmed pathologically and received etoposide or irinotecan combined with platinum chemotherapy in the first line.We take the patient's peripheral blood by EDTA vacuum anticoagulation blood vessels before chemotherapy in the first and second cycles.Flow cytometry was used to detect CD4+/CD8+,CD3+,CD3+CD4+,CD3+CD8+,CD19+,NK cells,CD4+CD8+%,and ??T cells in patients' peripheral blood to explore their relationship with stage of small cell lung cancer,the effect of chemotherapy on these immune indexes,and their relationship with chemotherapy efficacy.SPSS22.0 software was used for statistical analysis,it is considered that P<0.05 has statistically significant difference.Paired sample T test was used to analyze whether the changes of various indexes after chemotherapy were significant,and variance analysis was used to compare whether the differences between different stages,chemotherapy regimen,gender and age were statistically significant.Results:1.The average value of 95 patients' CD3+(t=-2.661;P=0.009)?CD3+CD4+(t=-2.122;P=0.036),CD3+CD8+(t=-2.266;P=0.026)cells increased after chemotherapy,while the average value of CD19+(t=3.497;P=0.001),??T cells(t=2.359;P=0.023)decreased after chemotherapy compared with before chemotherapy,and the difference was statistically significant.2.The average value of CD3+(t=-3.146;P=0.07),CD3+CD8+(t=-2.460;P=0.03)in partial response(PR)group increased after chemotherapy compared with before chemotherapy.while the average value of CD19+(t=2.985;P=0.031)decreased after chemotherapy,compared with before chemotherapy,and the difference was statistically significant.3.The average value of CD3+(t=-1.853;P=0.07),CD3+CD8+(t=-2.236;P=0.03)after chemotherapy was higher than that before chemotherapy in EP(etoposide combined with cisplatin)regimen group,while the average value of CD19+(t=2.279;P=0.031)was decreased after chemotherapy.And the difference was statistically significant.in IP(irinotecan combined with cisplatin)and EC(etoposide combined with carboplatin)chemotherapy group,after chemotherapy,the mean values of CD3+,CD3+CD8+ was also increased and the mean value of CD19+ was also decreased compared with before chemotherapy,but there was no significant difference in each index.4.The average value of ??T cells in extensive stage small cell lung cancer patients is higher than that in limited stage,and the difference is statistically significant(P=0.03).The average values of CD3+,CD4+,CD8+,CD19+ in the limited stage are higher than those in the extensive stage,but the difference is not statistically significant(P>0.05).5.Before chemotherapy,there was no significant difference in all indexes between chemotherapy-sensitive group and chemotherapy-insensitive group.After one cycle of chemotherapy,the average value of CD3+(P=0.039),CD8+(P=0.041)in chemosensitive group was higher than that in chemoinsensitive group,and the average value of CD19+ in chemosensitive group is higher than that in chemoinsensitive group(P=0.047).The difference is statistically significant(P>0.05).Conclusion:1.Chemotherapy can regulate the immune function of small cell lung cancer.After one cycle chemotherapy,cellular immunity increases and humoral immunity decreases.2.CD3+ and CD8+ can be used as effective markers to predict the short-term efficacy of chemotherapy for small cell lung cancer. |
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