外周血T淋巴细胞亚群与NK细胞检测在肺癌诊断及治疗中的意义

 目的　通过研究肺癌患者外周血T淋巴细胞亚群与NK细胞的表达及动态变化，分析其与肺癌发生、发展的关系及其临床意义。方法　运用流式细胞术检测66例肺癌患者（肺癌组）、60例肺结核患者（肺结核组）和60名健康人（健康对照组）外周血中CD+3、CD+3 CD+8、CD+3 CD+4、Th／Ts、CD+16 CD+56的表达；肺癌组还检测了化疗前后第3、7和20天外周血CD+3、CD+3 CD+8、CD+3 CD+4、Th／Ts、CD+16 CD+56 的表达。结果　肺癌组CD+3、CD+3 CD+4、Th／Ts、CD+16 CD+56表达明显降低（54.23±10.37）%、（34.23±8.03）%、1.35±0.20、（25.18±4.34）%]，与肺结核组（63.09±9.19）%、（39.46±12.74）%、1.51±0.41、（26.45±3.96）%]和健康对照组（69.68±8.31）%、（42.31±13.29）%、1.89±0.48、（29.44±2.51）%]比较差异均有统计学意义（均P＜0.05）；CD+3 CD+8 表达三组间差异均无统计学意义（均P＞0.05）。在化疗组中，化疗缓解组化疗后第3天CD+3、CD+3 CD+4、Th／Ts和CD+16 CD+56 表达较化疗前均显著降低（均P＜0.01），而CD+3 CD+8表达显著升高（P＜0.01）；第7天各项指标基本恢复到化疗前水平；第20天CD+3、CD+3 CD+4、Th／Ts和CD+16 CD+56 表达较化疗前均显著升高（均P＜0.05），而CD+3 CD+8表达显著降低（P＜0.05）。化疗未缓解组化疗前后各项指标的表达差异均无统计学意义（均P＞0.05）。在肺癌组中，ⅢA期、ⅢB期与ⅠA期比较、淋巴结转移N3组与N0组比较，CD+3、CD+3 CD+4、CD+3 CD+8、Th／Ts和CD+16 CD+56 表达差异均有统计学意义（均P＜0.05）；不同病理分型间各项指标表达差异均无统计学意义（均P＞0.05）。结论　动态监测肺癌患者外周血T淋巴细胞亚群与NK细胞可指导临床诊断和治疗，并有助于评估患者免疫功能状态。

Significance of peripheral blood T lymphocyte subsets and NK cells detection in lung cancer diagnosis and treatment

Objective　To analyse the relationship between T lymphocyte subsets and NK cells expression and dynamic changes in lung cancer patients' peripheral blood and the occurrence and development of cancer, and investigate their clinical significances. Methods　Flow cytometry was applied to detect 66 patients with lung cancer, 60 patients with pulmonary tuberculosis and 60 healthy persons peripheral blood CD+3, CD+3 CD+8, CD+3 CD+4, Th/Ts, CD+16 CD+56 expression. Lung cancer group peripheral blood CD+3, CD+3 CD+8, CD+3 CD+4, Th/Ts, CD+16 CD+56 expression were also detected on 3rd, 7th and 20th day before and after chemotherapy. Results　Lung cancer group CD+3, CD+3 CD+4, Th/Ts, CD+16 CD+56 expression decreased significantly (54.23±10.37) %, (34.23±8.03) %, 1.35±0.20, (25.18±4.34) %] and had significant differences compared with pulmonary tuberculosis group (63.09±9.19) %, (39.46±12.74) %, 1.51±0.41, (26.45±3.96) %] and healthy group (69.68±8.31) %, (42.31±13.29) %, 1.89±0.48, (29.44±2.51) %] (P < 0.05), but CD+3 CD+8 expression showed no significant difference (P > 0.05). In chemotherapy group, comparing with before chemotherapy, remission group CD+3, CD+3 CD+4, Th/Ts and CD+16 CD+56 expression decreased significantly (P < 0.01) on 3rd day after chemotherapy, while CD+3 CD+8 expression increased significantly (P < 0.01). On 7th day, each index recovered to the level of before chemotherapy basically. On 20th day, CD+3, CD+3 CD+4, Th/Ts and CD+16 CD+56 expression increased significantly (P < 0.05) compared with before chemotherapy, while CD+3 CD+8 expression significantly decreased (P < 0.05). Chemotherapy unease group had no significant difference (P > 0.05). Lung cancer of stage ⅢA and ⅢB compared with stage ⅠA, and lymph node metastasis in N3 group compared with N0 group, CD+3, CD+3 CD+4, CD+3 CD+8, Th/Ts and CD+16 CD+56 expression had significant differences (P < 0.05). Compared with their pathological types, each index had no significant difference (P > 0.05). Conclusion　Monitoring the peripheral blood T lymphocyte subsets and NK cells dynamic of lung cancer patients can guide the clinical diagnosis and treatment, and contribute to the assessment of immune function.