Ⅲ期非小细胞肺癌术前化疗的临床评价

对113例Ⅲ期非小细胞肺癌（NSCLC）患者进行了前瞻性随机对照试验,实验组63例,行术前化疗2个周期,其中CAP方案21例,MVP方案18例,NP方案24例,化疗后3周手术治疗;对照组50例先行手术治疗。实验组病期下调率、术后存活率明显高于对照组,而手术并发症、死亡率、术后生存质量方面均无统计学差异。     

化疗后老年非小细胞肺癌患者细胞免疫功能的变化

目的 研究老年非小细胞肺癌患者细胞免疫功能变化及化疗对其影响.方法 分别测定初次确诊的老年非小细胞肺癌患者29例、中青年非小细胞肺癌患者20例及健康老年人22例的T淋巴细胞亚群( CD3、CD4、CD8、CD4/CD8)及自然杀伤(NK)细胞的值,同时比较老年非小细胞肺癌患者化疗前和2个周期化疗结束、第3个周期开始前的T淋巴细胞亚群及NK细胞的数值.结果 老年非小细胞肺癌患者CD3、CD4、CD8、CD4/CD8及NK细胞分别为58.9±15.8、32.3±12.7、22.0±9.8、1.3±0.7、21.6±7.7,与中青年非小细胞肺癌患者65.9±7.2、38.5±7.6、23.1±9.2、1.5±0.7、16.8±6.2相比,CD3、CD4细胞降低,NK细胞增加(t=2.109、2.159、2.273,均P＜0.05),CD8、CD4/CD8变化差异无统计学意义(t=0.406、0.736,均P＞0.05);与健康老年人67.3±9.0、39.0±7.8、23.9±9.3、2.0±1.6、22.5±5.8比较,CD3、CD4、CD4/CD8明显降低(t=2.234、2.200、2.016,均P＜0.05),CD8、NK细胞变化差异无统计学意义(t=0.700、0.474,均P＞0.05);老年非小细胞肺癌患者化疗后分别为51.6±10.3、31.7±11.7、21.6±6.5、1.3±0.7、26.0±12.7,CD3明显减低(t=2.067,P＜0.05),CD4、CD8、CD4/CD8及NK细胞变化,差异无统计学意义(t=0.186、0.180、0.289、1.570,均P＞0.05).结论 老年非小细胞肺癌患者较中青年非小细胞肺癌患者及健康老年人免疫功能减低,化疗可进一步降低其细胞免疫功能.     

非小细胞肺癌患者K-ras的表达及其与预后的关系

目的探讨非小细胞肺癌（NSCLC）中K-ras的表达及与预后的关系。方法采用免疫组化方法检测160例病理证实的NSCLC组织中K-ras的表达,并根据结果分为K-ras（＋）组和K-ras（-）组,调查根治术后影响患者预后的因素。结果 NSCLC组织K-ras阳性表达率为61.2%,明显高于正常肺组织（P〈0.05）;K-ras表达与组织学类型、吸烟史及淋巴结转移有关。108例术后单纯化疗患者中,K-ras（-）组生存期长于K-ras（＋）组（P〈0.05）。结论 K-ras蛋白的表达与NSCLC的发生、发展及预后相关。     

化疗对行全肺切除的非小细胞肺癌患者预后的影响

目的探讨化疗对行全肺切除的非小细胞肺癌(NSCLC)患者预后的影响。方法本研究为队列研究, 采用非随机抽样方法选择美国SEER数据库2004-2016年收录的接受全肺切除术的NSCLC患者纳入研究, 其中单纯全肺切除术患者491例(全肺切除组), 全肺切除术联合化疗患者573例(联合化疗组)。分析化疗对行全肺切除术后的NSCLC患者预后的影响, 同时采用1∶1倾向性匹配方法分析2组患者预后情况。结果与全肺切除组比较, 联合化疗组累计生存率(30.1%比16.8%, χ²=79.30, P<0.001)和肿瘤特异性累计生存率(38.5%比34.3%, χ²=38.31, P<0.001)增高;通过倾向性匹配分析共获得329对单纯全肺切除术及联合化疗的NSCLC患者, 与单纯全肺切除的NSCLC患者比较, 联合化疗组的累计生存率(30.9%比17.7%, χ2=52.70, P<0.001)、肿瘤特异性累计生存率(39.8%比34.4%, χ²=27.38, P<0.001)均增高。通过多元逐步Cox回归模型分析显示, 不管是匹配前还是匹配后, 辅助化疗都是全肺切除术后患者总体生存或肿瘤特异性生存的独立影响因素。结论联合化疗有助于全肺切除术后NSCLC患者获得更好的预后。     

胸苷酸合成酶基因多态性与晚期非小细胞肺癌化疗敏感性的关系

目的探讨胸苷酸合成酶（TS）基因多态性与晚期非小细胞肺癌（NSCLC）患者对铂类为基础的化疗敏感性的关系。方法 101例晚期NSCLC患者采用顺铂或卡铂为主的方案化疗,2~3个周期后进行临床疗效评价。应用PCR方法分析患者TS 5′-非翻译区（UTR）基因多态性,以非条件logistic回归模型分析不同基因型与化疗敏感性的关系。结果 101例患者的总有效率为30.7%。携带TS 5′-UTR 2R等位基因患者的化疗敏感性是携带TS 5′-UTR 3R/3R基因型患者的1.54倍（95%CI=0.65~3.68,P=0.331）,但无统计学差异。携带3R/3R基因型患者粒细胞减少和恶心、呕吐的化疗毒性反应程度低于3R/2R和2R/2R基因型患者（P〈0.05）。结论 TS 5′-UTR基因可能不是NSCLC铂类药物化疗的独立敏感性预测因子。     

血清肿瘤标志物对老年非小细胞肺癌检测的临床意义

目的探讨血清肿瘤标志物癌胚抗原（CEA）、糖类抗原199（CA199）、鳞状上皮细胞癌抗原（SCC-Ag）、糖类抗原125（CA125）、细胞角蛋白19血清片段抗原21-1（CYFRA21-1）与非小细胞肺癌（NSCLC）患者病理分型以及分期的关系。方法2009年8月至2012年12月住院的90例年龄≥65岁NSCLC患者,全部经组织学诊断确认。应用电化学发光方法检测其血清中5种肿瘤标志物水平。结果血清中5种肿瘤标志物在肺癌患者中表达水平明显高于健康人组（P＜0.05）,在不同性别以及不同年龄段患者中的表达水平差异无统计学意义（P＞0.05）。CEA,CA199,CA125在腺癌中的水平明显高于鳞癌（P＜0.05）;SCC-Ag和CYFRA21-1在鳞癌中的水平明显高于腺癌（P＜0.05）。CYFRA21-1和CA125在N2和N3患者中表达水平明显高于N0和N1患者（P＜0.05）。CEA在有远处转移的患者明显高于无转移的患者（P＝0.041）。CEA和SCC-Ag转移部位越多,其表达越高（P＜0.05）。CEA在Ⅳb患者中表达明显高于Ⅰ+Ⅱ+Ⅲ和Ⅳa患者（P＝0.046）。结论 CEA,CA199,CA125对晚期腺癌的诊断价值较高,SCC-Ag和CYFRA21-1是诊断鳞癌有价值的标志物。5种肿瘤标志物表达与性别、年龄无明显相关。CEA与临床分期正相关,高表达预示分期晚,低表达则对分期参考作用小。CEA和SCC-Ag高浓度应高度警惕有无多部位转移。     

术后辅助化疗对早期非小细胞肺癌患者预后的影响研究

背景 手术切除是早期非小细胞肺癌(NSCLC)患者的首选治疗手段,但患者术后预后差异较大,其是否接受术后辅助化疗也存在争议.目的 分析术后辅助化疗对早期NSCLC患者预后的影响.方法 选取2013—2018年沧州市中心医院肿瘤科收治的早期NSCLC患者1460例为研究对象.收集患者一般资料,统计患者术后辅助化疗情况、术...     

非小细胞肺癌分期系统更新

第13届世界肺癌大会（WCLC）开幕伊始就公布了最新的肺癌分期系统。该系统是国际肺癌研究学会（IASLC）在完成了大量肺癌病例的数据回顾、验证及统计学分析后，向国际抗癌联盟（UICC）和美国癌症联合委员会（AJCC）提出修改建议并被采纳的。新系统将基于肿瘤大小的分组由3组增至5组，以利于指导辅助治疗的开展；将位于同一肺叶的卫星结节灶划为T3期；将伴胸膜结节或恶性胸膜播散的肿瘤由T4期改为M1期；将位于同侧肺不同肺叶的肿瘤由M1期改为T4期。     

回生口服液用于晚期非小细胞肺癌患者效果观察

目的观察回生口服液用于晚期非小细胞肺癌（NSCLC）的效果。方法将60例晚期NSCLC患者随机分为观察组及对照组各30例,两组均予长春瑞滨＋顺铂化疗,观察组在此基础上口服回生口服液,观察两组临床疗效、生活质量改善及不良反应发生情况。结果两组临床疗效无统计学差异;观察组生活质量改善有效率明显高于对照组,不良反应发生率明显低于对照组,P均〈0.05。结论回生口服液能改善NSCLC患者的生活质量,减轻化疗不良反应。     

老年人晚期非小细胞型肺癌适形放疗的临床研究

目的 探讨老年人晚期非小细胞型肺癌适形放射治疗的价值。方法 对24例老年晚期非小细胞型肺癌患者实施适形放疗，进行低姑息性达根治剂量的治疗。结果 全组1、2、3年的生存率分别是：91．67％、54．16％、43．33％；放疗期间无急性放射性肺炎发生；统计分析显示：治疗前是否合并上腔静脉综合征、肿瘤体积大小、治疗前后生活质量(KPS)评分、适形放疗剂量为有意义的预后因素。结论 适形放疗对老年人晚期非小细胞型肺癌有治疗意义。     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

目的 检测老年原发性非小细胞肺癌(NSCLC)患者外周血T细胞膜型CD28(mCD28)及血清中可溶性CD28(sCD28)的表达,探讨该分子增龄性改变与老年人肺癌发生发展之间的联系.方法 应用四色免疫荧光标记流式细胞术和酶联免疫吸附法对63例老年人NSCLC(老年肺癌组)外周血的mCD28和sCD28进行检测,将其结果 与老年肺良性病变组(老年非癌组35例)、老年健康组30例、青年健康组30例、青年肺良性病变组(青年非癌组20例)及青年肺癌组(20例)进行对比分析,并研究其与老年人肺癌临床病理特征之间的关系. 结果 老年肺癌组外周血mCD28的表达量[(19.27±6.93)%]显著低于其余各组(F=184.25,P<0.01).其血清sCD28含量[(72.00±6.85)μg/L]则显著高于其余各组(F=365.40,P<0.01);老年健康组外周血mCD28的表达量((46.09±7.34)%]明显低于青年健康组和青年非癌组,其血清sCD28的含量[(35.84±5.02)μg/L]则明显高于青年健康组和青年非癌组;老年非癌组[(42.84±5.82)%、(39.38±6.02)μg/L]与老年健康组比较,两者表达差异均无统计学意义;Logistic回归分析显示,增龄、mCD28表达下调、sCD28含量增加均与肺癌的发生有统计学关联(OR值分别为2.432、0.876,1.113);老年肺癌组Ⅲ～Ⅳ期mCD28和sCD28的表达[(16.51±5.64)%、(75.03±5.98)μg/L]与Ⅰ～Ⅱ期表达[(24.41±8.24)%、(66.73±7.52)μg/L]比较,差异均有统计学意义(t值分别为4.497、4.794,均为P<0.01),而不同病理类型之间比较,差异均无统计学意义(F值分别0.609、0.302,均为P0.05). 结论 呈增龄性下调的mCD28和增龄性上调的sCD28,在老年人原发性肺癌的形成和进展过程中可能起重要作用.     

Increasing underrepresentation of elderly patients with advanced colorectal or non-small-cell lung cancer in chemotherapy trials

Background: Elderly patients are underrepresented in chemotherapy trials for advanced colorectal cancer (CRC) and non‐small‐cell lung cancer (NSCLC). However, the change in underrepresentation over time has not been documented. Aims: This study aimed to quantify (i) the change in the median age of patients enrolled in clinical trials for metastatic CRC and NSCLC between 1982–1991 and 1992–2001 compared with the general colorectal and lung cancer population, and (ii) the proportion of trials with an upper age limit for eligibility. Methods: A retrospective review of data from the Victorian Cancer Registry and all large published randomized chemotherapy trials for advanced CRC and NSCLC between 1982 and 2001 was conducted. Results: The median age of patients with CRC enrolled in clinical trials remained constant between the two decades (62.0 and 62.2 years), whereas the median age of the CRC population increased from 68.4 to 70.2 years, increasing the median age difference from 6.4 to 8.0 years. The median age of patients with lung cancer in clinical trials increased from 59.8 to 61.8 years, whereas the median age of the lung cancer population increased from 67.4 to 70.4 years, widening the age difference from 7.6 to 8.6 years. More trials set an upper age limit for eligibility in the first decade than in the second decade for both CRC (51 vs 29%, P = 0.04) and NSCLC (68 vs 41%, P = 0.03). Conclusion: International clinical trials for CRC and NSCLC are becoming increasingly unsuitable for application to Australian patients because of the increasing age discrepancy, despite fewer trials restricting eligibility by age.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.