肺癌化疗患者血清TBNK淋巴细胞亚群水平变化与预后的相关性研究

吕丽媛; 杨冬明; 倪超; 钱方; 王鹏飞

doi:10.12354/j.issn.1000-8179.2024.20240088

肺癌化疗患者血清TBNK淋巴细胞亚群水平变化与预后的相关性研究

The correlation between changes in serum TBNK lymphocyte subset levels and prognosis of patients with lung cancer after chemotherapy

摘要

摘要:
目的探究肺癌化疗患者血清TBNK淋巴细胞亚群水平变化，并分析其与预后的相关性。
方法分析2020年1月至2023年6月就诊于北京京煤集团总医院的92例肺癌化疗患者，行标准方案化疗，检测首次化疗前、化疗1、3个周期后TBNK淋巴细胞亚群水平，化疗结束后3个月评价预后，分为缓解组（63例）、未缓解组（29例），分析TBNK淋巴细胞亚群水平与预后的相关性。
结果 Ⅲ期组化疗1、3个周期后CD3⁺、CD3⁺CD4⁺、CD3⁻CD19⁺低于Ⅳ期组，CD3⁺CD8⁺、CD3⁻CD16⁺CD56⁺高于Ⅳ期组（P<0.05）；缓解组化疗1、3个周期后CD3⁺、CD3⁺CD4⁺、CD3⁻CD19⁺低于未缓解组，CD3⁺CD8⁺、CD3⁻CD16⁺CD56⁺高于未缓解组（P<0.05）；肺癌化疗患者分期、预后与CD3⁺、CD3⁺CD4⁺、CD3⁻CD19⁺呈正相关，与CD3⁺CD8⁺、CD3⁻CD16⁺CD56⁺呈负相关（P<0.05）；化疗3个周期后TBNK淋巴细胞亚群联合预测肺癌化疗患者预后的AUC最大，为0.907（P<0.05）。
结论肺癌化疗患者外周血TBNK淋巴细胞亚群变化与免疫功能状态及预后有关，监测相关指标水平可预测肺癌化疗患者预后。

Abstract:
Objective To explore changes in the serum TBNK lymphocyte subset levels in patients with lung cancer undergoing chemotherapy and analyze their correlation with prognosis.
Methods Ninety-two patients undergoing standard regimen lung cancer chemotherapy who attended Beijing Jingmei Group General Hospital from January 2020 to June 2023 were selected. The level of TBNK lymphocyte subpopulations was detected before the first chemotherapy and after one and three cycles of chemotherapy. Their prognosis was evaluated 3 months after the end of chemotherapy and assigned into the remission group (63 cases) and the non-remission group (29 cases). The correlation between the levels of TBNK lymphocyte subsets and prognosis was analyzed.
Results The CD3⁺, CD3⁺CD4⁺, and CD3⁻CD19⁺ levels in the stage Ⅲ group were lower than those in the stage Ⅳ group after one and three cycles of chemotherapy, while the CD3⁺CD8⁺ and CD3⁻CD16⁺CD56⁺ levels were higher than those in the stage Ⅳ group (P<0.05). The CD3⁺, CD3⁺CD4⁺, and CD3⁻CD19⁺ levels in the remission group were lower than those in the non-remission group after one and three cycles of chemotherapy, while the CD3⁺CD8⁺ and CD3⁻CD16⁺CD56⁺ levels were higher than those in the non-remission group (P<0.05). The staging and prognosis of lung cancer patients undergoing chemotherapy positively correlated with CD3⁺, CD3⁺CD4⁺, and CD3⁻CD19⁺, and negatively correlated with CD3⁺CD8⁺ and CD3⁻CD16⁺CD56⁺ (P<0.05). The area under the curve (AUC) of the TBNK lymphocyte subsets combined to predict the prognosis of lung cancer patients after three cycles of chemotherapy was the highest, reaching 0.907 (P<0.05). The TBNK lymphocyte subsets have a good risk warning effect on the prognosis of patients with lung cancer undergoing chemotherapy.
Conclusions Changes in peripheral blood TBNK lymphocyte subsets in patients with lung cancer undergoing chemotherapy were associated with immune function status and prognosis. Monitoring the levels of the relevant indicators can predict the prognosis of patients with lung cancer undergoing chemotherapy.

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