摘要
目的观察晚期非小细胞肺癌（NSCLC）患者使用PD-1抑制剂治疗前后T淋巴细胞亚群及自然杀伤（NK）细胞的变化及临床疗效。方法收集广州现代医院2015年1月至2016年1月的晚期NSCLC患者23例，经化疗或靶向药物治疗失败后给予6周期的PD-1抑制剂治疗。采集患者治疗前后外周静脉血检测CD3^＋、CD4^＋、CD8^＋及NK细胞占外周血淋巴细胞的百分比。治疗后第2、4、6周期行胸部CT评价疗效。结果与治疗前相比，治疗后CD3^＋百分比（69．56％±7．81％：63．91％±6．43％，t=2．679，P=0．005）、CD4^＋百分比（39．01％±4．98％：36．09％±4．77％；t=2．031，P=0．024）和CD4^＋／CD8^＋（1．82±0．48：1．49±0．32；t=2．743，P=0．004）均有所升高，差异有统计学意义。与治疗前相比，治疗后CD8^＋百分比（24．08％±5．13％：26．04％±6．44％；t=1．142，P=0．130）和NK细胞百分比（22．68％±9．56％：21．45％±10．01％；t=0．426，P=0．337）变化不大，差异无统计学意义。完成PD-1抑制剂6个治疗周期时，NSCLC患者完全缓解3例、部分缓解10例、病情稳定8例、疾病进展2例。10例患者出现轻度困倦、口干、咳嗽、瘙痒、皮疹等不良反应，均可以耐受。结论PD-1抑制剂可提高患者的细胞免疫功能，取得更为理想的近期疗效，且不良反应可接受，或许可为NSCLC患者的治疗带来新的希望。
Objective To observe the changes of T lymphocyte subsets and natural killer （NK） ceils in patients with late stage non-small cell lung cancer （NSCLC） before and after treatment with PD-1 inhibitor and its clinical effect. Methods Totally 23 patients with NSCLC in Guangzhou Modern Hospital from January 2015 to January 2016 were collected. All patients were given 6 cycles of PD-1 inhibitor treatment after chemotherapy or targeted drug treatment failure. Peripheral venous blood was collected before and after treatment to detect the percentage of CD3^＋ , CD4^＋ , CD8^＋ and NK cells in peripheral blood lymphocytes. The curative effects were evaluated by chest CT after treatment of 2, 4, 6 cycles. Results Compared with before treatment, the proportions of CD3^＋ （69.56% ±7.81% vs. 63.91% ±6.43%, t =2.679, P =0.005）, CD4^＋ （39.01% ±4.98% vs. 36.09% ±4.77%, t =2.031, P =0.024） and CD4^＋/CD8^＋ （1.82±0.48 vs. 1.49 ± 0.32, t = 2. 743, P = 0.004） were increased after treatment, with significant differences. While compared with before treatment, the proportions of CD8^＋ （24.08% ± 5.13% vs. 26.04% ± 6.44%, t = 1. 142, P = 0. 130） and NK ceils （22.68% ±9.56% vs. 21.45% ± 10.01%, t = 0.426, P = 0.337） had little changes, with no significant differences. There were 3 patients with complete remission, 10 patients with partial remission, 8 patients with stable disease and 2 patients with progressive disease when completing 6 cycles of PD-1 inhibitor treatment. Ten patients showed untoward effects such as mild sleepiness, thirst, tussis, pruritus and rash, and they were well tolerable. Conclusion PD-1 inhibitor can improve the patient＇s cellular immune function, and can achieve a more satisfactory short-term efficacy and acceptable adverse reactions, which maybe bring new hopes for patients with NSCLC.
出处
《国际肿瘤学杂志》
CAS
2017年第3期169-172,共4页
Journal of International Oncology
关键词
免疫抑制剂
癌
非小细胞肺
T淋巴细胞亚群
治疗结果
PD-1抑制剂
Immunosuppressive agents
Carcinoma, non-small-cell lung
T lymphocyte subsets
Treatment outcome
PD-1 inhibitor
