幼稚和记忆T 细胞在NSCLC 放疗患者中的表达及其预后价值

  目的  探讨幼稚和记忆T细胞在非小细胞肺癌（non-small cell lung cancer，NSCLC）放疗患者外周血中的表达及其与预后的关系。  方法  采用流式细胞仪检测2014年9月至2016年5月解放军307医院40例接受放疗的NSCLC首诊患者，治疗前外周血中幼稚CD4+T细胞、记忆CD4+T细胞、幼稚CD8+T细胞、记忆CD8+T细胞，与14例健康人进行对比，并分析其与临床病理特征及预后的关系。  结果  与健康组相比，NSCLC患者幼稚CD4+T细胞下降（P=0.031），记忆CD4+T细胞和记忆CD8+T细胞升高（P=0.014、0.005）。与不吸烟患者相比，吸烟患者幼稚CD4+T细胞较低（P=0.043），记忆CD4+T细胞较高（P=0.024）。与ECOG评分1～2分者相比，0分者幼稚CD8+T细胞较低（P=0.017），记忆CD8+T细胞较高（P=0.020）。单因素分析显示幼稚CD4+T细胞较高组放疗后中位无进展生存期（median progression free survival，mPFS）更长（17个月vs. 9个月，P=0.044）、记忆CD4+T细胞较高组放疗后mPFS可能更短（9个月 vs. 15个月，P=0.069）。Cox多因素分析显示幼稚CD4+T细胞与患者放疗后无进展生存期（progression free survival，PFS）独立相关（P=0.009）。  结论  NSCLC患者外周血中幼稚T细胞储备下降，记忆T细胞上升。幼稚CD4+T细胞较高可能预示放疗后PFS更长。 

Naive and memory T cells in patients with non-small cell lung cancer treated with ra-diotherapy and their prognostic value

Objective:To investigate the expression of naive and memory T cells in peripheral blood of patients with non-small cell lung cancer (NSCLC) treated with radiotherapy and their prognostic value. Methods:Pretreatment peripheral blood samples obtained from 40 patients with NSCLC treated via radiotherapy and 14 healthy controls were analyzed by flow cytometry for naive CD4+T cells, memo-ry CD4+T cells, naive CD8+T cells, and memory CD8+T cells. We evaluated the relationships between these cells and patient character-istics and the prognosis of patients. Results:Compared with healthy controls, patients with NSCLC showed decreased naive CD4+T cells (P=0.031) and increased memory CD4+T cells (P=0.014) and memory CD8+T cells (P=0.005). Smokers showed lower naive CD4+T cells (P=0.063) and higher memory CD4+T cells (P=0.024) than nonsmokers. Patients with good performance status exhibited decreased na-ive CD8+T cells (P=0.017) and increased memory CD8+T cells (P=0.020). Univariate analysis revealed that increased naive CD4+T cells were correlated with better progression-free survival after radiotherapy (17 vs. 9 m, P=0.044), whereas elevated memory CD4+T cells may be correlated with poor progression-free survival after radiotherapy (9 vs. 15 m, P=0.069). Multivariate analysis demonstrated that naive CD4+T cells were independently associated with progression free survival after radiotherapy (P=0.009). Conclusion:Patients with NSCLC showed decreased naive T cells and increased memory T cells. Elevated naive CD4+T cells may predict longer progression free survival after radiotherapy.