晚期非小细胞肺癌患者DC-CIK治疗前的免疫状态与预后的关系

目的探讨晚期非小细胞肺癌(NSCLC)患者树突状细胞-细胞因子诱导的杀伤细胞(dendritic cellcytokine induced killers,DC-CIK)治疗前外周血CD4+CD25+CD127-调节性T细胞(regulatory T cells,TRegs)、CD3+CD56+细胞因子诱导的杀伤细胞(cytokine induced killer cells,CIKs)、CD4+/CD8+T细胞比值与预后的关系。方法采用流式细胞仪技术检测45例晚期NSCLC患者DC-CIK治疗前、后外周血CD4+CD25+CD127-TRegs、CD3+CD56+CIKs、CD4+和CD8+T细胞,并与患者临床特征进行相关分析;采用Cox回归模型分析治疗前CD4+CD25+CD127-TRegs、CD3+CD56+CIKs、CD4+/CD8+T细胞比值对患者预后的影响。结果晚期NSCLC患者DC-CIK治疗前、后比较,治疗后患者外周血CD4+T细胞减少,CD8+T细胞增多,CD4+/CD8+T细胞比值下降,差异均有统计学意义(均P<0.05);原发病灶瘤体最长直径越大,患者治疗前外周血TRegs越多,CIKs越少(均P<0.05);生存分析显示,治疗前TRegs越多,患者预后越差,生存期越短,且TRegs>7×109/L影响患者的生存(P<0.05)。结论晚期NSCLC患者外周血TRegs是判断预后的独立预测指标。

Relationship between prognosis and immune status of patients with advanced NSCLC before DC-CIK immunotherapy

Objective: To investigate the relationship between the immune status before dendritic cell-cytokine induced killer (DC-CIK) biotherapy and the prognosis of patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty-five patients with advanced NSCLC received DC-CIK therapy. The levels of CD4+CD25+CD127- regulatory T cells (TRegs) and CD3+CD56+CIKs and the ratio of CD4+/CD8+ T cells in peripheral blood were measured with flow cytometry. Clinicopathological characteristics of patients were evaluated by Spearman analysis. Prognostic factors for advanced NSCLC were evaluated by Cox regression. Results: The ratio of CD4+/CD8+ T cells in peripheral blood after CD-CIK therapy declined significantly (P<0.05). CD4+CD25+CD127-TRegs level was positively and CD3+CD56+CIKs level was negatively correlated with tumor size (both P<0.05). The level of CD4+CD25+CD127-TRegs before therapy was negatively correlated with survival rate (P<0.05). Conclusion: The level of regulatory T cells in peripheral blood is an independent prognostic factor for patients with advanced NSCLC. ©, 2015, Journal of Practical Oncology, Editorial Board. All right reserved.