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目的:研究晚期肺癌患者化疗5个周期T淋巴细胞表面抑制性分子(TIM3、PD-1、CTLA-4)的变化。方法:应用流式细胞仪技术检测33例初治晚期肺癌患者化疗5个周期T淋巴细胞表面抑制性分子的表达变化。并与23例健康志愿者作对比。结果:化疗前晚期肺癌患者外周血T淋巴细胞表面抑制性分子的表达明显高于健康对照组,差异具有统计学意义(P<0.05)。化疗后19例临床疗效评价为PR或SD的患者,其外周血CD4+TIM3+T淋巴细胞、CD8+TIM3+T淋巴细胞、CD4+PD-1+T淋巴细胞、CD8+PD-1+T淋巴细胞比例在化疗5个周期中降低,差异有统计学意义(P<0.05);而CD4+CTLA-4+T淋巴细胞、CD8+CTLA-4+T淋巴细胞比例呈现下降趋势,与化疗前相比无显著性差异(P>0.05)。结论:晚期肺癌患者的免疫功能处于抑制状态。有效的化疗可降低T淋巴细胞表面抑制性分子表达,改善肿瘤对免疫功能的抑制。
Objective: To study the changes of T lymphocyte surface inhibitory molecules (TIM3, PD-1, CTLA-4) in 5 patients with advanced lung cancer undergoing chemotherapy. Methods: Flow cytometry was used to detect the expression of inhibitory molecules on T lymphocytes in 33 patients with newly diagnosed advanced lung cancer during 5 cycles of chemotherapy. And compared with 23 healthy volunteers. Results: The expression of inhibitory molecules on T lymphocytes in patients with advanced lung cancer before and after chemotherapy was significantly higher than that in healthy controls (P <0.05). After chemotherapy, the clinical efficacy of 19 patients with PR or SD were evaluated. The levels of CD4 + TIM3 + T lymphocytes, CD8 + TIM3 + T lymphocytes, CD4 + PD-1 + T lymphocytes, CD8 + PD-1 + T (P <0.05). The proportion of CD4 + CTLA-4 + T lymphocytes and CD8 + CTLA-4 + T lymphocytes showed a decreasing trend. Compared with that before chemotherapy No significant difference (P> 0.05). Conclusion: The immune function of patients with advanced lung cancer is in a state of inhibition. Effective chemotherapy can reduce the surface of T lymphocyte inhibitory molecule expression and improve tumor immune function inhibition.