免疫细胞及炎症因子对晚期肺癌一线化疗效果的预测价值

doi:10.3969/j.issn.1671-7171.2024.05.030

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摘要【目的】探讨T淋巴细胞亚群、肿瘤浸润T淋巴细胞(Tils)及炎症因子对晚期肺癌一线化疗效果的预测价值。【方法】检测98例首诊TNM分期为Ⅲ/Ⅳ期的非小细胞肺腺癌患者的血清白细胞介素1α(IL-1α)、IL-6、IL-17、γ-干扰素(INF-γ)水平及T淋巴细胞亚群CD4⁺T、CD8⁺T、调节性T细胞、CD57⁺细胞、Granzyme B⁺细胞、CD45RO⁺细胞比例;所有患者均接受紫杉醇注射液+顺铂化疗,治疗4个周期后评定疗效,并据此分为有效组和无效组,分析化疗无效的影响因素及预测疗效的有效标志物。【结果】化疗后,98例患者中69例化疗有效,29例无效。无效组患者淋巴结转移占比及调节性T细胞、IL-1α表达水平均高于有效组(P<0.05),CD57⁺细胞、CD45RO⁺细胞比例均低于有效组(P<0.05)。多因素逐步Logistic回归分析结果显示,调节性T细胞、IL-1α水平高是肺癌患者化疗无效的危险因素(P<0.05),CD57⁺细胞、CD45RO⁺细胞比例高是保护因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,调节性T细胞、CD57⁺细胞、CD45RO⁺细胞、IL-1α水平预测化疗效果的灵敏度分别为82.76%、86.21%、89.66%、93.10%,四者联合的灵敏度、特异度和曲线下面积(AUC)分别为82.76%、97.10%、0.957。【结论】T淋巴细胞亚群、Tils及炎症因子水平与晚期肺癌治疗效果密切相关,其可作为预测疗效的敏感指标。

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	卢超
	胡志清
	吴亚斌

关键词 ：肺肿瘤, T淋巴细胞亚群, 炎症趋化因子类/血液, 药物疗法, 治疗结果

Abstract：【Objective】This study aims to explore the predictive value of T lymphocyte subsets, tumor-infiltrating lymphocytes (Tils), and inflammatory markers on the effectiveness of first-line chemotherapy in advanced lung cancer.【Methods】Serum levels of interleukin 1α (IL-1α), IL-6, IL-17, and interferon-gamma (INF-γ), as well as the proportions of T lymphocyte subsets including CD4⁺T cells, CD8⁺T cells, regulatory T cells, CD57⁺ cells, Granzyme B⁺ cells, and CD45RO⁺ cells were measured in 98 newly diagnosed patients with stage Ⅲ/Ⅳ non-small cell lung adenocarcinoma. All patients received a chemotherapy regimen of paclitaxel injection and cisplatin for four cycles. Treatment effectiveness was assessed post-treatment, and patients were categorized into the responsive and non-responsive groups. Factors influencing the non-responsiveness and potential biomarkers for predicting treatment outcomes were analyzed.【Results】Out of 98 patients, 69 were responsive to chemotherapy, while 29 were non-responsive. Non-responsive patients had a higher proportion of lymph node metastasis, and higher levels of regulatory T cells and IL-1α expression (P<0.05), while their proportions of CD57⁺ and CD45RO⁺ cells were lower than those in the responsive group (P<0.05). Multivariate stepwise logistic regression analysis indicated that high levels of regulatory T cells and IL-1α were risk factors for ineffective chemotherapy response (P<0.05), whereas CD57⁺ and CD45RO⁺ cells were protective factors (P<0.05). Receiver operating characteristic (ROC) curve analysis showed sensitivities of 82.76%, 86.21%, 89.66%, and 93.10% for regulatory T cells, CD57⁺ cells, CD45RO⁺ cells, and IL-1α levels, respectively. The combined sensitivity, specificity, and area under the curve (AUC) of regulatory T cells, CD57⁺ cells, CD45RO⁺ cells, and IL-1α levels were 82.76%, 97.10%, and 0.957, respectively.【Conclusion】T lymphocyte subsets, Tils, and inflammatory markers are closely related to the treatment outcomes of advanced lung cancer and can serve as sensitive indicators for predicting therapeutic efficacy.

Key words： Lung Neoplasms T-Lymphocyte Subsets Chemokines/BL Drug Therapy Treatment Outcome

收稿日期: 2023-12-27

中图分类号:

R734.2

引用本文:

卢超, 胡志清, 吴亚斌. 免疫细胞及炎症因子对晚期肺癌一线化疗效果的预测价值[J]. 医学临床研究, 2024, 41(5): 750-753.
LU Chao, HU Zhiqing, WU Yabin. Predictive Value of Immune Cells and Inflammatory Markers on the Efficacy of First-Line Chemotherapy in Advanced Lung Cancer. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 750-753.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.05.030 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I5/750

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