肺腺癌细胞免疫指标、癌胚抗原、血清铁蛋白与预后因素的关系

目的 研究肺腺癌患者细胞免疫指标、癌胚抗原(CEA)、血清铁蛋白(SF)与预后因素的关系.方法 回顾性分析81例肺腺癌患者的临床资料,统计分析其一般情况、T淋巴细胞亚群、CEA和SF变化及其与TNM分期、淋巴结转移的关系.结果 (1)CD4+、CD4+/CD8+随TNM分期增加呈降低趋势;CD8+、CEA及SF随TNM分期增加呈增高趋势.(2)有淋巴结转移较无淋巴结转移患者,CD4+、CD4+/CD8+明显降低[分别为(25.8±7.5)%比(34.9±9.1)%、0.7±0.4比1.1±0.5,P＜0.01],CD8+、CEA及SF明显增高[分别为(39.7±9.5)%比(34.0±8.1)%、(14.2±10.8)μg/L比(6.1±6.1)μg/L、(374.4±192.9)μg/L比(276.3±167.4)μg/L,P＜0.01或＜0.05].(3)CEA(+)较CEA(-)患者,CD4+、CD4+/CD8+明显降低[分别为(26.9±7.5)%比(35.6±9.7)%、0.7±0.4比1.2±0.5,P＜0.01],CD8+及SF明显增高[分别为(40.4±9.1)%比(32.4士7.1)%、(371.9±181.5)μg/L比(261.5±174.0)μg/L,P＜0.01].(4)SF(+)较SF(-)患者,CD4+、CD4+/CD8+明显降低[分别为(26.7±7.9)%比(33.3±9.7)%、0.7±0.4比1.1±0.5,P＜0.01],CD3+、CD8+及CEA明显增高[分别为(71.1±8.5)%比(66.2 4±10.4)%、(40.5±8.6)%比(34.2±8.7)%、(13.7±10.6)μg/L比(7.3 4±7.1)μg/L,P＜0.05或＜0.01].结论 肺腺癌患者存在不同程度的细胞免疫功能紊乱,且与CEA、SF变化及TNM分期、淋巴结转移密切相关.

The relationship between cytoimmunologic factors,carcinoembryonic antigen,serum ferritin and prognostic factors in patients with lung adenous cancer

Objective To observe the roh of cytoimmunologic factors,careinoembryonic antigen (CEA),serum ferritin(SF)and prognostic factors in patients with Iung adenous cancer.Methods Eightyone patients with lung adenous cancer were analyzed retrospectively.The clinical features as well as the alternation of T-lymphocyte subsets and its relationship with CEA.SF,disease stage and metastasis of lymph node were studied.Results(1)The percentage of CD4+ T cell decreased and that of CD8+T cell increased,the ratio of CD4+/CD8+ went down accompanied by the increase of disease stage.CEA and SF increased as the dmease stage increased.(2)Thedecrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in patients with metastasis of lymph nodes[LN(+)](p＜0.01).The increase of percentage of CD8+Tcell and CEA,SF level was obvious in LN(+)(P＜0.01 or＜0.05).(3)The decrease of percentage of CD4+T cell and the ratio of CD4+/CD4+ was obvious in CEA (+)(P＜0.01).The increase of percentage of CD8+ T cell and SF level was obvious in CEA (+)(P＜0.01).(4)The decrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in SF(+)(P＜0.01).The increase of percentage of CD3+ CD8+ T cell and the CEA level was obvious in SF (+)(P＜0.05 or＜0.01).Conclusion Disorder of cytoimmunologic situation exists in patients with lung adenous cancer,and it is closely correlatod with the CEA,SF level disease stage and metastasis of lymph node.