初诊肺癌患者多次化疗外周血免疫相关指标动态变化的研究

发布时间：2018-09-11 14:09

【摘要】：目的:探索免疫治疗与化疗相结合的有利切入点,为临床免疫治疗介入提供试验依据。方法:收集2015年11月至2016年12月新乡医学院第一附属医院初诊的23例肺癌患者,全部患者均完成连续5个周期的化疗,采用流式细胞术方法检测化疗过程中患者外周血免疫相关指标如CD4~+T细胞、CD8~+T细胞、CD19~+B细胞和CD16~+、CD56~+、NK细胞比率,T细胞表面共信号分子PD-1、PD-L1、CD137、CTLA-4、CCR-4、LAG-3以及细胞因子表达情况。分析多周期过程中,上述指标动态变化趋势。结果:在肺癌患者多个周期的化疗过程中,机体CD8~+T淋巴细胞、CD19~+B淋巴细胞和CD16~+、CD56~+、NK细胞水平下调,CD4~+T淋巴细胞数量增加,差异具有统计学意义(P0.05);T细胞表面共抑制分子PD-1、CTLA-4和CCR-4随治疗进行表达下调,差异具有统计学意义(P0.05)。结论:肺癌患者在多个周期的化疗中,实施淋巴细胞亚群数量及T细胞表面共抑制分子监测具有重要意义,化疗中后期针对免疫检查点高表达患者,联合应用PD-1抗体、PD-L1抗体、CTLA-4抗体或CCR-4抗体可能具有更优的治疗效果。
[Abstract]:Objective: to explore the beneficial breakthrough point of combination of immunotherapy and chemotherapy, and to provide experimental basis for clinical immunotherapy intervention. Methods: from November 2015 to December 2016, 23 patients with lung cancer were collected from the first affiliated Hospital of Xinxiang Medical College. Flow cytometry was used to detect the expression of PD-1,PD-L1,CD137,CTLA-4,CCR-4,LAG-3 and cytokines on the surface of CD4~ T cell / CD8T cell / CD19 ~ B / CD16~ / CD56 ~ + NK cell. The dynamic change trend of the above indexes is analyzed in the multi-cycle process. Results: during multiple cycles of chemotherapy in lung cancer patients, the levels of CD8~ T lymphocytes CD19 ~ B lymphocytes and CD16~ CD56 ~ + NK cells decreased the number of CD4 ~ T lymphocytes increased. The difference was statistically significant (P0.05). The expression of PD-1,CTLA-4 and CCR-4 on the surface of T cells was down-regulated with the treatment, and the difference was statistically significant (P0.05). Conclusion: it is important for lung cancer patients to monitor the number of lymphocyte subsets and co-suppressor molecules on the surface of T cells in multiple cycles of chemotherapy. The combination of PD-1 antibody, PD-L1 antibody, CTLA-4 antibody or CCR-4 antibody may have better therapeutic effect.
【作者单位】：新乡医学院第一附属医院生物治疗实验室;新乡医学院第一附属医院肿瘤二科;
【基金】：国家自然科学青年基金项目(编号:81201765) 河南省高校重点科研项目(编号:15A320063) 新乡医学院研究生科研创新支持计划项目(编号:YJSCX201509Z) 河南省骨干青年教师培养计划项目(编号:2016GGJS-105)资助~~
【分类号】：R734.2

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