恶性实体瘤患者外周血T淋巴细胞亚群变化规律与放射性损伤及预后分析及其临床意义

The Change Rule of Peripheral Blood T Lymphocyte Subsets in Malignant Solid Tumor Patients and Its Clinical Significance in Radioactive Damage and Prognosis Analysis

摘要: 目的：本文旨在探讨部分实体肿瘤患者T细胞亚群异常变化规律，了解肿瘤患者自身机体的免疫动态，及其与预后及放化疗毒性反应的关系。方法：采用流式细胞技术(FCM)检测并记录94例实体瘤患者放化疗前T淋巴细胞亚群的基线水平，利用相同的技术检测同时期44例正常体检者外周血T淋巴细胞亚群水平。随访6个月以上，观察及评价恶性实体瘤组的预后及放射性损伤情况。结果：1）实体瘤患者放化疗后其T淋巴细胞亚群水平较治疗前基线水平有所下降，差异具有统计学意义；2）放化疗前T淋巴细胞亚群中淋巴细胞总数、CD3总T细胞计数、CD4辅助/诱导T细胞计数与不同预后组(CR, PR, SD, PD)之间存在统计学差异，进一步两两比较显示组间差异仍具有统计学意义；3）合并化疗的实体瘤患者其T淋巴细胞亚群水平较未合并化疗者下降明显，差异具有统计学意义。结论：1）恶性实体肿瘤患者初始治疗前即存在免疫受损；2）放化疗杀伤肿瘤细胞的同时可能导致患者机体免疫功能减低；3）淋巴细胞总数、CD3总T细胞计数、CD4辅助/诱导T细胞计数基线水平低下者其预后较差。

Abstract: Objective: The purpose of this paper is to explore T cell subgroup abnormalities in solid tumors patients, comprehend the tumor immune dynamics of cancer patients’ own body, and its rela-tionship with radioactive damage and prognosis. Methods: Using flow cytometry (FCM) technique to measure and record the baseline levels of T lymphocyte subsets of 94 patients with solid tumor before radiation and chemotherapy and using the same technique to detect and record 44 cases healthy people’s peripheral blood T lymphocyte subsets level at the same time, then following up for 6 months or more, observing and evaluating the prognosis and radioactive damage of solid tumor group. Results: T lymphocyte subgroup baseline level had declined in solid tumor patients’ group after radiation and chemotherapy, the difference remained statistically significant (P value < 0.05). There were statistical differences between different prognosis groups (CR, PR, SD, PD) in total number of lymphocyte, CD3 total T cell count and CD4 auxiliary/induction T cell counts level before radiation and chemotherapy and further comparison also showed that the difference remained statistically significant. T lymphocyte subgroup level is decreased in combined chemotherapy patients with solid tumor and meanwhile the difference remained statistically significant.