非小细胞肺癌外周血T淋巴细胞活化抗原表达的临床研究

ＨＬＡ ＤＲ是人类主要组织相容性复合体 (ＭＨＣ)Ⅱ类分子的主要抗原之一 ,ＣＤ2 5是细胞膜上的白介素 2受体 (ＩＬ 2Ｒ) ,ＣＤ69是一种早期激活抗原 ,三者均为Ｔ淋巴细胞表面的细胞表型 ,其表达水平与肿瘤的关系已成为目前研究的热点。我们进行了这方面研究 ,以期探讨肺癌患者的细胞免疫功能状态及临床意义。对象与方法　对象 :肺癌患者 50例 ,均经手术病理和穿刺活检证实。其中男性 33例 ,女性 1 7例。年龄 35～ 76岁 ,平均 (50 0± 3 5)岁。进行手术的有 2 0例 ,化疗的有 30例。有淋巴结转移者 38例 ,无淋巴结转移者 1 2例。组织学分类…     

老年非小细胞肺癌外周血CD25和HLA-DR^＋表达的临床研究

目的观察老年非小细胞肺癌患者外周血T淋巴细胞活化抗原CD3^＋／CD25和CD3^＋／HLA-DR的表达，进一步探讨肺癌的免疫功能。方法应用流式细胞双色免疫荧光标记技术对45例老年肺癌患者外周血T淋巴细胞活化抗原CD3^＋／CD25和CD3^＋／HLA—DR表达进行荧光免疫检测，并与中青年肺癌组、正常老年对照组和老年良性病变组，进行对比研究。结果45例老年肺癌患者外周血T淋巴细胞中CD3^＋／CD25^＋和CD3^＋／HLA-DR表达明显低于正常对照组和良性病变组（P〈0．01）。老年组和中青年组之间其表达水平比较也有显著性差异（P〈0．05或〈0．01）。正常老年对照组和老年良性病变组之间无显著性差异（P〉0．05）。Ⅲ期、Ⅳ期和Ⅰ期、Ⅱ期之间CD3^＋／CD25^＋和CD3＋／HLA-DR表达比较，差异有显著性（P〈0．01）。结论检测外周血T淋巴细胞活化抗原CD3^＋／CD25^＋和CD3^＋／HLA-DR^＋的表达水平对了解老年肺癌患者的免疫状态和预后评估具有十分重要的意义。     

老年原发性非小细胞肺癌患者外周血T淋巴细胞Fas/FasL的表达及临床意义

目的 探讨T细胞表面凋亡分子Fas及其配体与老年原发性非小细胞肺癌(NSCLC)发生发展之间的联系.方法 应用五色免疫荧光标记流式细胞术对63例老年NSCLC患者外周血T细胞表面Fas及FasL的表达进行检测,并与老年良性病变组(老年非癌组)、老年健康组以及年轻健康组进行比较,同时分析它们与临床病理特征之间的关系.结果 Fas及FasL在老年健康组外周血T细胞上的表达明显高于年轻健康组(P＜0.01);两者在老年非癌组中表达与老年健康组比较无统计学意义;Fas在老年肺癌组中表达显著高于老年健康组及老年非癌组(P＜0.01),而FasL在老年肺癌组中表达与老年健康组及老年非癌组比较无统计学意义;T细胞Fas的表达水平与老年肺癌的临床TNM分期、细胞分化程度以及淋巴结转移状态密切相关(P＜0.05或P＜0.01),而与病理类型无关.结论 呈增龄性上调的T细胞表面Fas抗原在老年人原发性肺癌的形成和演变过程中发挥着重要作用.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

目的 检测老年原发性非小细胞肺癌(NSCLC)患者外周血T细胞膜型CD28(mCD28)及血清中可溶性CD28(sCD28)的表达,探讨该分子增龄性改变与老年人肺癌发生发展之间的联系.方法 应用四色免疫荧光标记流式细胞术和酶联免疫吸附法对63例老年人NSCLC(老年肺癌组)外周血的mCD28和sCD28进行检测,将其结果 与老年肺良性病变组(老年非癌组35例)、老年健康组30例、青年健康组30例、青年肺良性病变组(青年非癌组20例)及青年肺癌组(20例)进行对比分析,并研究其与老年人肺癌临床病理特征之间的关系. 结果 老年肺癌组外周血mCD28的表达量[(19.27±6.93)%]显著低于其余各组(F=184.25,P<0.01).其血清sCD28含量[(72.00±6.85)μg/L]则显著高于其余各组(F=365.40,P<0.01);老年健康组外周血mCD28的表达量((46.09±7.34)%]明显低于青年健康组和青年非癌组,其血清sCD28的含量[(35.84±5.02)μg/L]则明显高于青年健康组和青年非癌组;老年非癌组[(42.84±5.82)%、(39.38±6.02)μg/L]与老年健康组比较,两者表达差异均无统计学意义;Logistic回归分析显示,增龄、mCD28表达下调、sCD28含量增加均与肺癌的发生有统计学关联(OR值分别为2.432、0.876,1.113);老年肺癌组Ⅲ～Ⅳ期mCD28和sCD28的表达[(16.51±5.64)%、(75.03±5.98)μg/L]与Ⅰ～Ⅱ期表达[(24.41±8.24)%、(66.73±7.52)μg/L]比较,差异均有统计学意义(t值分别为4.497、4.794,均为P<0.01),而不同病理类型之间比较,差异均无统计学意义(F值分别0.609、0.302,均为P0.05). 结论 呈增龄性下调的mCD28和增龄性上调的sCD28,在老年人原发性肺癌的形成和进展过程中可能起重要作用.     

非小细胞肺癌外周血CD44和CD54表达的定量研究

目的 探讨非小细胞肺癌患者外周血淋巴细胞中CD44和CD54表达与临床病理的关系。方法 应用流式细胞术对50例肺癌患者外周血淋巴细胞中CD44和CD54表达与临床病理的关系。方法 应用流式细胞术对50例肺癌患者外周血淋巴细胞中CD44和CD54表达进行荧光免疫检测,并与正常对照组（30名）及肺部良性病变组（25例）进行对比研究。结果 50例肺癌患者外周血淋巴细胞中CD44和CD54表达明显高于正常对照组及良性病变组（P＜0．01）。良性病变组和正常对照组之间CD44和CD54的表达比较,差异无显著性（P＞0．05）。肺癌伴淋巴结转移CD44和CD54高于不伴淋巴结转移者（P＜0．01）;Ⅲ期、Ⅳ期和Ⅰ期、Ⅱ期之间CD44表达比较,差异有显著性（P＜0．01）;Ⅳ期和Ⅰ期、Ⅱ期、Ⅲ期之间CD54表达比较,差异有显著性（P＜0．01）。CD44和CD54表达与肺癌组织学分级有明显相关性（P＜0．05或0．01）;与鳞癌和腺癌没有相关性。结论 应用流式细胞仪检测CD44和CD54的表达水平可作为肺癌转移和预后的指标。     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

Objective To explore the expression of membrane form of CD28 (mCD28) on T lymphoeytes and the serum level of soluble CD28 (sCD28) in elderly patients with primary non-small cell lung cancer (NSCLC) in order to investigate the relationship between age-related changes of CD28 and the development of NSCLC in elderly patients. Methods 63 elderly patients with NSCLC, 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled in this study. The mCD28 on T cells and the serum level of sCD28 were measured by four-color flow eytometric assay and enzyme linked immunosorbent respectively, and the relationship between CD28 and clinical characteristics of NSCLC was analysed Results The expression of mCD28 was decreased and the serum level of sCD28 was increased in elderly patients with NSCLC compared with the other groups (F= 184.25, P<0. 01 ; F= 365.40, P<0.01). The expression of mCD28 was significantly lower and the level of sCD28 was significantly higher in elderly healthy donors than those in young healthy donors and young patients with lung benign lesion (P<0. 05). There were no significantly statistical differences in expression of mCD28 and level of sCD28 between elderly healthy donors and elderly patients with lung benign lesion [(42.84±5.82)% vs. (46.09±-7.34)%, (39.38±6.02)μg/L vs. (35.84±5.02)μg/L, P>0. 05]. Logistic regression analysis showed that aging (OR=2. 432), down-regulation of mCD28 expression (OR=0. 876) and up-regulation of sCD28 level (OR= 1. 113) were the risk factors for lung cancer. In the elderly patients with NSCLC, there were significant differences in mCD28 expression and sCD28 level between stages Ⅲ-Ⅳ and stages Ⅰ-Ⅱ [(16. 51± 5.64)% vs. (24.41±8.24)%, (75.03±5.98) μg/L vs. (66.73±7.52)μg/L; t=4.497,4.794, both P <0. 01]. However, there were no significantly statistical differences among different pathological types (F=0. 609, 0. 302, both P > 0. 05). Conclusions The down-regulation of mCD28 expression and up-regulation of sCD28 level with advancing age play an important role in the oncogenesis and development of primary non-small cell lung cancer in the elderly patients.     

T lymphocyte subsets and PD-1 expression on lymphocytes in peripheral blood of patients with non-small cell lung cancer

The incidence rate and mortality rate of lung cancer (LC) are very high. This study aimed to analyze the T lymphocyte subsets and programmed death-1 (PD-1) expression on lymphocytes in the peripheral blood of non-small cell lung cancer (NSCLC) patients and explore whether there were changes in cellular immunity in NSCLC. Peripheral blood samples were collected from newly diagnosed NSCLC patients and healthy individuals. The T lymphocyte subsets and PD-1 expression were evaluated using flow cytometry. Single-sample gene set enrichment analysis (ssGSEA) was performed to explore the correlations of PD-1 expression with infiltration patterns for tumor-infiltrating T immune cells. By flow cytometry, two populations of lymphocytes in NSCLC patients were observed. Apart from a population of normal volume lymphocytes (Lym1), the other population had larger volume and more particles (Lym2). Compared with the healthy group, the proportion of CD4+ T cells and PD-1 expression on Lym1 was higher, and that of CD8+ T cells was lower in the NSCLC group. In the NSCLC group, the proportions of CD3+ T cells, CD8+ T cells, CD4+CD8+ T (DPT) cells, and PD-1 expression were higher on Lym2 than those on Lym1 (P < .05). ssGSEA showed that tumor infiltrating immune T cells were positively correlated with PD-1 expression. The PD-1 expression on lymphocytes increased in recurrent patients who treated with PD-1 inhibitor. Lym2 may be tumor-infiltrating lymphocytes (TILs) which upregulated PD-1 expression in NSCLC. PD-1 expression on lymphocytes may be used as a recurrence indicator for NSCLC patients treated with PD-1 inhibitors.     

CK19与CEA在非小细胞肺癌外周血微转移中的对比研究

目的检测非小细胞肺癌（NSCLC）患者外周血细胞角蛋白（CK19）及癌胚抗原（CEA）的表达,探讨对检测NSCLC微转移的可行性。方法应用RT—PCR技术检测48例NSCLC患者、15例肺良性疾病（BLD）患者和10例健康人外周血CK19及CEA mRNA的表达。结果NSCLC患者外周血中CK19及CEA mRNA的阳性表达率分别为68．75％、58．33％,在BLD组中表达率分别为13．33％、6．67％,而对照组外周血中均无表达,NSCLC组CK19及CEA表达均高于BLD组及对照组（P〈0．05）。外周血CK19及CEA的表达与临床分期及淋巴结转移密切相关,与病理类型及分化程度无关。结论CK19与CEA均可作为检测NSCLC患者外周血微转移较为合适的分子标志物,联合检测有助于提高检测的阳性率。     

NSCLC对小剂量紫杉醇同步放化疗的观察

目的观察小剂量紫杉醇配合同步放疗对局部晚期非小细胞肺癌（NSCLC）的疗效和毒副反应。方法 88例Ⅲ期NSCLC患者随机分为两组：A组（小剂量紫杉醇配合同步放疗）45例,同步放化疗中放疗采用三维适形放疗技术,DT60～66Gy/30～33f/6～7w。化疗使用小剂量紫杉醇方案,紫杉醇45mg/m^2qw（放疗期间）;B组43例,放疗方式同A组,化疗使用EP方案,依托泊苷50mg/m^2d1-5,d29-33;顺铂50mg/m^2d1、8、29、36。治疗完成后评价疗效和不良反应。结果 A组总有效率（CR＋PR）75.6%;1、2、3年生存率分别为48.9%,31.1%,22.2%;中位生存时间18.8个月。B组总有效率76.7%;1、2、3年生存率分别为51.7%,30.2%,21%,中位生存时间19.2个月。两组间总有效率和生存率均无显著统计学差异（P〉0.05）。毒副反应主要是放射性肺炎、放射性食管炎和骨髓抑制,两组间有显著统计学差异（P〈0.05）。结论小剂量紫杉醇同步放化疗与EP方案同步放化疗疗效相当,并有降低毒副作用的优点,值得临床推广。     

老年非小细胞肺肿瘤患者红细胞输注疗效分析

目的:探讨非小细胞肺肿瘤(NSCLS)患者红细胞输注的临床疗效。方法:分析2011-01-2013-12我院158例已经确诊的NSCLS患者无效输注的发生情况。结果:158例NSCLS患者中,红细胞无效输注有38例(24.05%),且NSCLSⅣ期和输血次数10次以上的患者发生红细胞无效输注在50%以上。结论:红细胞无效输注与患者输血次数和NSCLS分期有关,输血次数愈多和癌症晚期(Ⅳ期),无效输血率也就越高。     

长春瑞滨单药及联合卡铂治疗初治的老年人中晚期非小细胞肺癌

目的 观察长春瑞滨单药及长春瑞滨联合卡铂治疗初治的65岁及以上非小细胞肺癌(NSCLC)患者的疗效、毒副反应、生存时间和生活质量,探讨适合中晚期老年非小细胞肺癌的化疗方案.方法 65岁及以上ⅢB期和Ⅳ期老年非小细胞肺癌患者80例,随机分为长春瑞滨单药治疗组和长春瑞滨联合卡铂治疗联合组.单药组长春瑞滨25 mg/m2第1天及第8天静脉滴注.每21天为1个周期.联合组长春瑞滨25 mg/m2第1天及第8天静脉滴注,卡铂AUC5第1天静脉滴入.每21天为1个周期.结果 单药组有效率35.0%,中位生存时间9.0个月,1年生存率35.0%,联合组有效率42.5%,中位生存时间10.0个月,1年生存率37.5%,两组差异无统计学意义(χ2=0.296,P=0.586).化疗后联合组的3～4度粒细胞减少(χ2=7.168,P=0.014)、3～4度血小板减少(χ2=5.165,P=0.048)及3～4度恶心呕吐(χ2=6.275,P=0.025)显著高于单药组.治疗后长春瑞滨单药组的缺乏食欲(χ2=2.600,P=0.011)、乏力(χ2=3.169,P=0.002)及疼痛评分(χ2=2.257,P=0.027)高于联合组,两组比较差异有统计学意义.结论 长春瑞滨单药是更适宜老年人中晚期NSCLS的化疗方案.     

吉非替尼治疗晚期非小细胞肺癌疗效观察

目的 探讨表皮生长因子酪氨酸激酶抑制剂-吉非替尼对晚期非小细胞肺癌(NSCLC)的治疗效果。方法 对66例应用Iressa(250mg／d)治疗的晚期NSCLC患者生活质量、生存期等临床资料，采用Logistic回归分析、x^2检验、t检验的方法进行统计学分析。生活质量评估依据欧洲癌症研究和治疗组织QLQ-C30和QLQ-Lcl3问卷中文版进行。结果 本组患者用Iressa治疗的有效率为33％(22／66)，疾病控制率(有效 稳定)为70％(46／66)。患者生活质量及相关临床症状QLQ．C30评分中各功能状态和综合生活质量评分的均值显著增加，改善率为91％～100％；QLQ-LC13评分中各项疾病相关症状评分的均值显著降低，改善率为73％～100％。药物的不良反应主要为Ⅰ级或Ⅱ级皮疹和腹泻，经对症处理可缓解。结论 吉非替尼用于晚期NSCLC治疗疗效确切，同时可改善患者的相关症状、提高生活质量。     

老年人非小细胞肺癌肿瘤组织胸苷酸合成酶的表达

胸苷酸合成酶(TS)是新一代抗叶酸代谢药物作用的主要酶,已有研究表明,非鳞癌患者肿瘤组织TS表达水平与抗叶酸类化疗药物的疗效成负相关[1].本研究拟分析老年非小细胞肺癌(NSCLC)患者术后肿瘤组织标本中TS蛋白的表达水平与其临床病理特征之间的关系,旨在为老年患者的化疗提供新的依据.     

108例老年人晚期非小细胞肺癌三维适形放射治疗的疗效分析

目的分析三维适形放射治疗（3D-CRT）在老年人非小细胞肺癌（NSCLC）的临床应用效果和放射损伤情况。方法接受3D-CRT的108例老年人晚期NSCLC中,男性102例,女性6例,中位年龄72岁。适形放疗单次剂量5～8Gy,隔日1次,总剂量68～82Gy。结果108例全部完成了放射治疗计划,完全缓解21例（19.4%）,部分缓解73例（67.6%）,无变化12例（11.1%）,恶化2例（1.9%）,总有效率87.0%。1、2、3年总生存率分别为65%、33%、28%。急性放射性肺炎2级8例,3级2例;晚期放射性肺炎2级11例,3级5例。结论采用3D-CRT技术治疗老年人晚期NSCLC有比较好的近期疗效,无严重的不良反应,有助于提高肿瘤的局部控制率,改善患者生存质量,减少并发症。