多西他赛对复发转移性乳腺癌免疫功能的影响

目的：探讨多西他赛化疗前、化疗2周期评价疗效时复发转移性乳腺癌（MBC）患者外周血淋巴细胞亚群比率的变化及影响因素。方法应用流式细胞仪检测34例行多西他赛一线化疗的复发MBC患者化疗前、化疗2周期评价疗效时外周血淋巴细胞亚群CD3+T淋巴细胞、CD3+/CD4+T淋巴细胞、CD3+/CD8+T淋巴细胞、CD3－/CD16+56+自然杀伤细胞（NK）、CD3+/CD16+56+T淋巴细胞、CD19+B淋巴细胞、CD4+/CD25+调节性T细胞（Treg细胞）、CD8+/CD28－T淋巴细胞和CD8+/CD28+T淋巴细胞]比率，并进一步分析患者临床病理因素对于外周血淋巴细胞亚群变化的影响。结果34例患者化疗后CD3+总T淋巴细胞、CD3+/CD4+T淋巴细胞及CD19+B淋巴细胞比率均较化疗前下降（P=0.002、0.044、0.006），下降平均比率分别为2.2%、4.7%、3.1%。中位年龄﹥54岁的患者CD19+B淋巴细胞下降比率较中位年龄≤54岁的患者小（P=0.031）；中位OS﹥3.6个月的患者CD3+总T淋巴细胞下降比率较中位OS≤33.6个月的患者小（P=0.038）。结论多西他赛化疗后MBC患者外周血总T、B淋巴细胞比率下降，免疫功能降低，而相对保留较好的T淋巴细胞免疫功能的患者可能有更好的生存获益。

The effect of docetaxel on immunological function of patients with metastatic breast cancer

Objective To explore the change of lymphocytes subsets ratio in peripheral blood of patients with meta-static breast cancer (MBC) before and after chemotherapy with docetaxel and the influence factors. Method The ratio of lymphocyte subsets (CD3+T cell, CD3+/CD4+T cell, CD3+/CD8+T cell, CD3-/CD16+56+NK cell, CD3+/CD16+56+T cell, CD19+B cell, CD4+/CD25+T cell,CD8+/CD28-T cell, CD8+/CD28+T cell) in peripheral blood of 34 MBC patients were analyzed with flow cytometry before and after chemotherapy. The result was analyzed in combination with patients’clini-copathological characteristics. Result The ratio of CD3+T cell, CD3+/CD4+T cell and CD19+B cell decreased signifi-cantly after two cycles of docetaxel chemotherapy (P=0.002, 0.044, 0.006) in all the 34 patients, with decreases of 2.2%, 4.7%and 3.1%, respectively. The patients at age>54 years (median) had less CD19+B lymphocytes decrease compared with those at age≤54 years (P=0.031);while the patients with overall survival (OS)>33.6 months had less CD3+T lym-phocytes decrease compared with those with OS ≤33.6 months (P=0.038). Conclusion Docetaxel chemotherapy de-creased the ratio of T and B lymphocyte as well as the immunological function of MBC patients, and relatively better re-tention of T cell immunological function might offer better survival benefit.