放射治疗对肺癌患者免疫功能的影响

目的 探讨放射治疗对肺癌患者CD3+、CD4+、CD8+、CD4+/CD8+的影响。 方法 选择丽水市中心医院接受放射治疗的肺癌患者90例进行研究,收集患者放射剂量、放射靶体积等临床资料,流式细胞仪测定外周血CD3+、CD4+、CD8+、CD4+/CD8+。 结果 放射治疗后,CD3+含量[(61.48±1.86)%]和放射治疗前[(61.12±1.83)%]比较差异无统计学意义(P>0.05),CD4+、CD4+/CD8+含量[(26.85±1.28)%、0.71±0.06]均低于治疗前[(36.24±1.25)%、1.22±0.08](P<0.05),CD8+含量[(37.92±1.66)%]高于治疗前[(29.79±1.12)%](P<0.05);放射治疗后,CD3+异常比例(32.2%)和放射治疗前(34.4%)比较差异无统计学意义(P>0.05),CD4+、CD4+/CD8+异常比例(85.6%、67.8%)均高于治疗前[(53.3%、31.1%)](P<0.05);放射治疗剂量 ≥ 60 Gy患者CD3+、CD4+、CD8+、CD4+/CD8+[(63.43±1.85)%、(27.23±1.28)%、(37.53±1.17)%、0.72±0.07]与放射剂量<60 Gy[(61.12±1.77)%、(26.77±1.31)%、(38.08±1.36)%、0.69±0.05]比较差异无统计学意义(P>0.05);放射治疗靶体积>440 cm3患者CD3+含量(61.88±2.23)%和靶体积 ≤ 440 cm3者(59.99±2.17)%比较差异无统计学意义(P>0.05),CD4+、CD4+/CD8+[(24.37±1.68)%、0.68±0.06]均低于靶体积 ≤ 440 cm3者[(29.86±1.59)%、0.89±0.05](P<0.05),CD8+含量[(41.46±2.59)%]高于靶体积 ≤ 440 cm3者[(34.27±2.13)%](P<0.05)。 结论 肺癌患者放射治疗前存在免疫功能低下,放射治疗后免疫功能进一步下降,肺癌患者的免疫功能和放射靶体积有关,靶体积越大免疫功能越差。 

Effect of radiation therapy on immune function of patients with lung cancer

Objective To explore the influence of radiation therapy on CD3+,CD4+,CD8+,CD4+/CD8+ in patients with lung cancer. Methods The clinical data of 90 patients with lung cancer undergoing radiotherapy in Lishui Central Hospital were studied.The radiation dose and target volume were recorded.The CD3+,CD4+,CD8+ and CD4+/CD8+ in peripheral blood were determined by flow cytometry. Results After radiotherapy,the CD3+[(61.48±1.86)%]was no significant difference with that before radiotherapy[(61.12±1.83)%],P>0.05,the levels of CD4+ and CD4+/CD8+[(26.85±1.28)%,0.71±0.06]were significantly lower than those before the treatment[(36.24±1.25)%,1.22±0.08](P<0.05),the CD8+ content[(37.92±1.66)%]was higher than that before the treatment[(29.79±1.12)%],P<0.05.After radiotherapy,CD3+ abnormality ratio (32.2%) was no significant difference with that before radiotherapy (34.4%),P>0.05,the percentage of abnormal CD4+,CD4+/CD8+(85.6%,67.8%) was lower than that before the treatment (53.3%,31.1%),P<0.05.The CD3+,CD4+,CD8+,CD4+/CD8+ radiation therapy dose ≥ 60 Gy patients[(63.43±1.85)%,(27.23±1.28)%,(37.53±1.17)%,0.72±0.07]was not statistically significant with radiation dose<60 Gy[(61.12±1.77)%,(26.77±1.31)%,(38.08±1.36)% and 0.69±0.05],P>0.05.There was no significant difference of CD3 between target volume>440 cm3[(61.88±2.23)%]and target volume ≤ 440 cm3[(59.99±2.17)%],P>0.05,the CD4+,CD4+/CD8+[(24.37±1.68)%,0.68±0.06]were significantly lower than those with target volume ≤ 440 cm3,the CD8 content[(41.46±2.59)%]was higher than that of target volume ≤ 440 cm3[(34.27±2.13)%],P<0.05. Conclusion The immune of lung cancer patients before radiotherapy is dysfunction.The immune function after radiation therapy decreases further.The immune function of patients with lung cancer is related to radiation target volume,the larger the target volume,the lower the immune function.