非小细胞肺癌患者外周血CD8+T细胞表面PD-1的表达及其临床意义

目的 观察非小细胞肺癌（NSCLC）患者外周血中CD8+T细胞表面程序性死亡蛋白1（PD-1）分子的表达，并分析其表达与部分临床病理参数的关系。方法 分别取90例NSCLC（50例鳞癌、40例腺癌）患者新鲜血液，以30例健康体检者作对照；Ficoll密度梯度离心法分离外周血单核细胞，通过免疫磁珠法获得CD8+T细胞，流式细胞仪检测PD-1+CD8+T细胞的表达率；并比较不同年龄、性别、病理类型、临床分期、分化程度及有无淋巴结转移的NSCLC患者外周血中CD8+T细胞表面PD-1的表达水平的差异。结果 肺鳞癌组、肺腺癌组、健康对照组的PD-1+CD8+T表达阳性率依次为（18.32±5.20）%、（18.68±5.41）%和（7.44±2.59）%，肺鳞癌组和肺腺癌组均高于健康对照组（F=58.344，P＜0.001）；PD-1+CD8+T表达与临床分期、淋巴结转移有关（P＜0.05）；且临床分期越高，PD-1+CD8+T表达阳性率进行性增高，差异有统计学意义（rs=0.875，P＜0.001）；PD-1+CD8+T阳性率与年龄、性别、病理类型、组织分化程度无关（P＞0.05）。结论 PD-1在NSCLC患者外周血CD8+T细胞表面高表达，并与临床分期、淋巴结转移显著有关，提示PD-1分子可能通过与肿瘤细胞上的PD-L1相互作用而抑制CD8+T细胞功能，导致肿瘤进展，从而参与NSCLC免疫逃逸过程，在NSCLC的发生发展中起到至关重要的作用。

Relationship between the expression of PD-1 on CD8+T cell and the clinical pathological parameters in non-small cell lung cancer

Objective To explore the expression characteristics of programmed death-1（PD-1） on CD8+T in the peripheral blood from patients with non-small cell lung cancer （NSCLC） as well as the relationship between level of PD-1 and clinicopathologic variables. Methods Ninety NSCLC patients， including 50 squamous cell carcinoma and 40 adenocarcinoma， and thirty healthy controls were selected. CD8+T cells were obtained from the peripheral blood mononuclear cells. The positive expression ratio of the PD-1 on the CD8+T cell surfaces in the peripheral blood was detected using flow cytometry. We then analyzed the relationship of PD-1 expression with age， gender， pathological classification， clinical stage， pathological degree and lymphatic metastasis. Results The positive expression ratio of PD-1 on CD8+T cell in the peripheral blood of the three groups were （18.32±5.20）%， （18.68±5.41）% and （7.44±2.59）%， and the data of NSCLC patients was higher than that of the healthy controls （F=58.344， P＜0.001）.The results were obviously related to the clinical stage and lymphatic metastasis （P＜0.05）， which positively correlated with the clinical stage of the NSCLC （rs=0.875， P＜0.001）. However， no difference was observed on age， gender， pathological classification and pathological degree （P＞0.05）. Conclusion The positive expression ratio of PD-1 on CD8+T cell in the peripheral blood of NSCLC patients was higher than that of the healthy controls， and the high expression ratio of PD-1 on CD8+T cell were significantly related to the clinical stages and lymphatic metastasis. The elevated level of PD-1 might be related with the immune escape of the NSCLC， thus playing a crucial role in the occurrence and development of NSCLC.