幼稚和记忆T 细胞在NSCLC 放疗患者中的表达及其预后价值

刘超; 吴世凯; 刘广贤; 申戈; 王微; 孟祥颖; 孙冰; 丛阳; 赵耀巍; 高红军

doi:10.3969/j.issn.1000-8179.2017.04.411

幼稚和记忆T 细胞在NSCLC 放疗患者中的表达及其预后价值

Naive and memory T cells in patients with non-small cell lung cancer treated with radiotherapy and their prognostic value

摘要

摘要:
目的探讨幼稚和记忆T细胞在非小细胞肺癌（non-small cell lung cancer，NSCLC）放疗患者外周血中的表达及其与预后的关系。
方法采用流式细胞仪检测2014年9月至2016年5月解放军307医院40例接受放疗的NSCLC首诊患者，治疗前外周血中幼稚CD4⁺T细胞、记忆CD4⁺T细胞、幼稚CD8⁺T细胞、记忆CD8⁺T细胞，与14例健康人进行对比，并分析其与临床病理特征及预后的关系。
结果与健康组相比，NSCLC患者幼稚CD4⁺T细胞下降（P=0.031），记忆CD4⁺T细胞和记忆CD8⁺T细胞升高（P=0.014、0.005）。与不吸烟患者相比，吸烟患者幼稚CD4⁺T细胞较低（P=0.043），记忆CD4⁺T细胞较高（P=0.024）。与ECOG评分1～2分者相比，0分者幼稚CD8⁺T细胞较低（P=0.017），记忆CD8⁺T细胞较高（P=0.020）。单因素分析显示幼稚CD4⁺T细胞较高组放疗后中位无进展生存期（median progression free survival，mPFS）更长（17个月vs. 9个月，P=0.044）、记忆CD4⁺T细胞较高组放疗后mPFS可能更短（9个月 vs. 15个月，P=0.069）。Cox多因素分析显示幼稚CD4⁺T细胞与患者放疗后无进展生存期（progression free survival，PFS）独立相关（P=0.009）。
结论 NSCLC患者外周血中幼稚T细胞储备下降，记忆T细胞上升。幼稚CD4⁺T细胞较高可能预示放疗后PFS更长。

Abstract:
Objective To investigate the expression of naive and memory T cells in peripheral blood of patients with non-small cell lung cancer (NSCLC) treated with radiotherapy and their prognostic value.
Methods Pretreatment peripheral blood samples obtained from 40 patients with NSCLC treated via radiotherapy and 14 healthy controls were analyzed by flow cytometry for naive CD4⁺T cells, memory CD4⁺ T cells, naive CD8⁺ T cells, and memory CD8⁺ T cells. We evaluated the relationships between these cells and patient characteristics and the prognosis of patients.
Results Compared with healthy controls, patients with NSCLC showed decreased naive CD4⁺T cells (P=0.031) and increased memory CD4⁺T cells (P=0.014) and memory CD8⁺ T cells (P=0.005). Smokers showed lower naive CD4⁺T cells (P=0.063) and higher memory CD4⁺T cells (P=0.024) than nonsmokers. Patients with good performance status exhibited decreased naive CD8⁺T cells (P=0.017) and increased memory CD8⁺T cells (P=0.020). Univariate analysis revealed that increased naive CD4⁺T cells were correlated with better progression-free survival after radiotherapy (17 vs. 9 m, P=0.044), whereas elevated memory CD4⁺T cells may be correlated with poor progression- free survival after radiotherapy (9 vs. 15 m, P=0.069). Multivariate analysis demonstrated that naive CD4⁺T cells were independently associated with progression free survival after radiotherapy (P=0.009).
Conclusion Patients with NSCLC showed decreased naive T cells and increased memory T cells. Elevated naive CD4⁺ T cells may predict longer progression free survival after radiotherapy.

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