慢阻肺疾病合并肺癌患者的辅助性T细胞水平与疾病发生的关系

目的探讨血清辅助性T细胞17(Th17)相关因子水平与慢性阻塞性肺疾病(简称慢阻肺)合并非小细胞肺癌的关系。方法选取2016年1月至2018年6月住院治疗,首次确诊为非小细胞肺癌患者436例,包括慢阻肺合并非小细胞肺癌组140例,单纯非小细胞肺癌组296例;另收集同期在本院体检的同年龄段健康人296例为健康对照组。收集患者清晨空腹外周静脉血5 mL,采用液相芯片技术检测Th17细胞相关因子血清水平。结果慢阻肺合并非小细胞肺癌组和单纯非小细胞肺癌组患者血清Th17相关细胞因子水平明显高于健康对照组,差异有统计学意义(P<0.05);血清Th17相关细胞因子水平在慢阻肺合并非小细胞肺癌组与单纯非小细胞肺癌组之间差异无统计学意义(P>0.05),但慢阻肺合并非小细胞肺癌组与单纯非小细胞肺癌组均存在增高的趋势。在吸烟者中,血清Th17相关细胞因子水平升高可明显增加非小细胞肺癌的发生风险(P<0.05),校正受试者性别、年龄、吸烟情况后,血清Th17相关细胞因子水平升高可明显增加慢阻肺合并非小细胞肺癌组和单纯非小细胞肺癌组的非小细胞肺癌发生风险,差异有统计学意义(P<0.05)。结论 1.慢阻肺合并非小细胞肺癌患者和单纯非小细胞肺癌患者的血清Th17细胞相关因子水平均明显高于健康对照组,提示无论是否合并慢阻肺,Th17细胞相关炎症反应均与非小细胞肺癌密切相关。2.血清Th17细胞相关因子水平升高是肺癌发生的独立危险因素。

Relationship between helper T cell level and disease occurrence in patients with chronic obstructive pulmonary disease complicated with lung cancer

Objective To explore the relationship between serum helper T cell 17(Th17)related factors and the occurrence of chronic obstructive pulmonary disease(COPD)complicated with non-small cell lung cancer.Methods 436 patients with non-small cell lung cancer diagnosed from January 2016 to June 2018 were selected,including 140 patients with COPD complicated with non-small cell lung cancer and 296 patients with simple non-small cell lung cancer.Other 296 healthy people at the same age class were collected as the healthy control group during the same period.Fasting peripheral venous blood was collected for 5 ml in the morning.The levels of serum helper T cell 17(Th17)related factors were detected by liquid chip technique.Results The levels of serum Th17-related cytokines were significantly higher in COPD patients complicated with NSCLC and patients with NSCLC alone than in healthy controls(P<0.05).There was no statistically significant difference in serum Th17-related cytokines between the COPD with NSCLC group and the simple NSCLC group(P>0.05),but the level of Th17-related cytokines was escalated in both group.In smokers,elevated levels of serum Th17 related cytokines could obviously increase the risk of non-small cell lung cancer(P<0.05).After correcting gender,age,smoking status of the subjects,it found elevated serum Th17 related cytokines levels could significantly increase the risk for non-small cell lung cancer in both the COPD complicated with non-small cell lung cancer group and the pure non-small cell lung cancer group with a statistically significant difference(P<0.5).Conclusion 1.The serum levels of Th17 cell-related factors in COPD patients complicated with NSCLC and patients with NSCLC alone are significantly higher than those in the healthy control group,suggesting that whether or not COPD is involved,Th17 cell-related inflammatory reaction is closely related to NSCLC.2.Elevated serum levels of Th17 cytokines are independent risk factors for lung cancer.