Changes And Clinical Significance Of Peripheral Blood Lymphocyte Phenotype In Patients With Non-small Cell Lung Cancer Before And After Chemotherapy

Objective:To investigate the changes of peripheral blood T lymphocyte subsets,their absolute counts,and natural killer cell receptor expression levels in patients with non-small cell lung cancer at different stages and before and after treatment.To investigate the effects of chemotherapy on lymphocyte activation and immune function in patients with non-small cell lung cancer.Methods:A total of 50 patients with primary non-small cell lung cancer diagnosed by pathology（25 in each of stagesⅠ^ⅢA andⅢB^Ⅳ）were collected from Hebei Chest Hospital in May 2018 and March 2019,and 10 healthy patients were selected as the control group during the same period.Early morning fasting venous blood was collected,flow cytometry was used to detect the expression levels of helper T lymphocytes（CD3 CD4）,suppressor T lymphocytes（CD3 CD8）,regulatory T lymphocytes（Treg）and the expression levels of NK cell activating receptors NKG2D,NCRs（NKp30,NKp44,NKp46）,and inhibitory receptors CD158a,CD158b,and CD158e in healthy people and the patients before chemotherapy,and after 2 cycles of chemotherapy.At the same time,T lymphocyte subpopulations were statistically analyzed based on the T lymphocyte human leukocyte DR antigen（HLA-DR）expression activity,and their receptor levels were statistically analyzed based on the NK cell CD56 expression intensity.Statistical analysis was performed on the expression levels of T lymphocytes and NK cells in different genders,ages,smoking,histological types,and stages.Comparative analysis was performed on the lymphocytes and absolute counts of T lymphocytes before and after chemotherapy in patients with intermediate to advanced（ⅢB^Ⅳ）non-small cell lung cancer.Results:1.The expression of CD3⁺CD4⁺and CD4⁺HLA-DR⁺of patients with different stages of non-small cell lung cancer were lower than the control,and the expression of CD3⁺CD8⁺was higher than the control;The absolute count of CD3⁺CD4⁺in stageⅠ^ⅢA was higher than that in stageⅢB^Ⅳ.The expression of CD25^highCD127^low in the control was lower than the patients with non-small cell lung cancer,the differences were statistically significant（P<0.05）.2.For patients with stage IIIB^Ⅳnon-small cell lung cancer,the expression of CD3⁺CD4⁺and CD4⁺HLA-DR⁺increased after 2 cycles of chemotherapy,and the expressions of CD3⁺CD8⁺,CD8⁺HLA-DR⁺and CD25^highCD127^low were lower than those before chemotherapy.The differences were statistically significant（P<0.05）.3.The expression of CD56^dim activating receptors NKG2D and NKp30 of non-small cell lung cancer patients with stage IIIB^Ⅳwere lower than those in healthy subjects and patients with stageⅠ^ⅢA;The expression of CD56^dim activating receptor NKp44 of non-small cell lung cancer patients with stageⅠ^ⅢA and stageⅢB^Ⅳwere lower than that of healthy control,the difference were statistically significant（P<0.05）.4.The percentage of CD56^dim activating receptors NKp30 and NKp44 expression of patients of non-small cell lung cancer with stage IIIB^Ⅳafter chemotherapy were higher than those before chemotherapy,the difference was statistically significant（P<0.05）.5.The expression level of CD8⁺in peripheral blood of non-small cell lung cancer patients over 65 years old was higher than the age group under 65 years old;the activated CD4⁺and CD8⁺cells in adenocarcinoma patients were higher than the squamous cell carcinoma patients.Conclusion:1.Patients with non-small cell lung cancer at different stages had poor immune function,both the percentage of T lymphocyte subsets and their absolute counts were significantly lower than those of the control group.2.Patients with advanced non-small cell lung cancer have recovered immune function after chemotherapy.Their immune function status is positively correlated with the percentage of helper T lymphocyte and absolute count,and the absolute count of T lymphocytes can better reflect the body’s immune function status.It is considered that chemotherapy can play a role in immune regulation by reversing the immunosuppressive microenvironment of tumors.3.The expression of activated receptors on CD56^dimNK cells in stageⅢB^Ⅳis lower than that in stageⅠ^ⅢA,which may be related to the decrease of NK cell activating receptors caused by tumor suppressive microenvironment;and the expression of NK cell activating receptors NKp30 and NKp44 can be increased after chemotherapy,it is speculated that chemotherapy can exert its killing effect on tumors by increasing the body’s NK cell activity.