摘要
目的观察晚期乳腺癌患者新辅助化疗前后T淋巴细胞亚群变化及与临床疗效的关系。方法选取2017年1月-2020年4月在辽阳市中心医院首次治疗的100例女性晚期乳腺癌患者作为观察组,另选取同期体检的年龄相仿健康女性40人作为对照组。观察组患者予新辅助化疗方案:多西他赛75 mg/m^(2),静滴,d 2;表柔吡星80 mg/m^(2),静滴,d 1;环磷酰胺500 mg/m^(2),静注,d1。21 d为1个周期,均接受3个周期化疗。采用流式细胞仪检测观察组患者化疗前、化疗3个周期后和对照组患者的CD3^(+)、CD4^(+)、CD8^(+)细胞亚群水平。结果治疗前,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著低于对照组(t=2.336、25.024、11.162,P均<0.05),CD8^(+)水平显著高于对照组(t=4.094,P<0.05);化疗后,观察组CD4^(+)及CD4^(+)/CD8^(+)水平显著升高(t=4.094、2.252,P均<0.05)。经新辅助化疗后,有效组患者CD3^(+)、CD4^(+)、CD4+/CD8^(+)水平均明显上升(t=2.966、9.484、4.524,P均<0.05);而无效组患者CD3^(+)、CD4^(+)/CD8^(+)水平显著降低(t=2.313、2.472,P均<0.05),CD8+水平显著升高(t=2.931,P<0.05)。经新辅助化疗后,年龄≤60岁组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显上升(t=2.976、7.219、3.880,P均<0.05);而年龄>60岁组患者CD8^(+)水平显著升高(t=2.345、3.590,P均<0.05)。经新辅助化疗后,Ⅲ期患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平显著上升(t=2.856、7.103、3.814,P均<0.05),而Ⅳ期患者CD3^(+)显著降低(t=2.534,P<0.05),CD8^(+)水平显著升高(t=5.715,P<0.05)。结论晚期乳腺癌患者免疫功能低下,新辅助化疗可提高患者免疫功能水平,且患者年龄越小、分期越低,免疫功能改善效果越好,T淋巴细胞亚群变化与患者临床疗效关系密切。
Objective To observe the changes of T lymphocyte subsets and their relationship with clinical curative effect in patients with advanced breast cancer before and after neoadjuvant chemotherapy.Methods A total of 100 patients with advanced breast cancer who were treated for the first time in the hospital from January 2017 to April 2020 were enrolled as observation group,while another 40 healthy women with the same age who underwent physical examinations during the same period in the hospital were enrolled as control group.The observation group was given neoadjuvant chemotherapy(75 mg/m^(2)docetaxel,intravenous drip,d 2.80 mg/m^(2)epirubicin,intravenous drip,d 1.500 mg/m^(2)cyclophosphamide,intravenous,d 1).21 d was defined as 1 cycle.All underwent chemotherapy for 3 cycles.Flow cytometry was applied to detect levels of CD3^(+),CD4^(+)and CD8+in observation group before chemotherapy,at 3 cycles after chemotherapy and in control group.Results Before treatment,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in observation group were significantly lower than those in control group(t=2.336,25.024,11.162,all P<0.05),while CD8+was significantly higher than that in control group(t=4.094,P<0.05).After chemotherapy,levels of CD4^(+)and CD4^(+)/CD8^(+)in observation group were significantly increased(t=4.094,2.252,all P<0.05).After neoadjuvant chemotherapy,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in effective group were significantly increased(t=2.966,9.484,4.524,all P<0.05).After neoadjuvant chemotherapy,levels of CD3^(+)and CD4^(+)/CD8^(+)in ineffective group were significantly decreased(t=2.313,2.472,all P<0.05),while level of CD8+was significantly increased(t=2.931,P<0.05).After neoadjuvant chemotherapy,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in patients aged not older than 60 years old were significantly increased(t=2.976,7.219,3.880,all P<0.05).After neoadjuvant chemotherapy,level of CD8^(+)in patients aged older than 60 years old were significantly increased(t=2.345,3.590,all P<0.05).After neoadjuvant chemotherapy,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in patients at stageⅢwere significantly increased(t=2.856,7.103,3.814,all P<0.05).After neoadjuvant chemotherapy,CD3^(+)level in patients at stageⅣwas significantly decreased(t=2.534,P<0.05),while CD8+level was significantly increased(t=5.715,P<0.05).Conclusions The immune function of patients with advanced breast cancer was low.Neoadjuvant chemotherapy could improve their immune function level.The younger the patients,the lower the cancer staging and the better the improvement effect of immune function.The changes of T lymphocyte subsets were closely related to the clinical curative effect.
作者
黄克华
张健
于勇
HUANG Ke⁃hua;ZHANG Jian;YU Yong(Department of General Surgery,Liaoyang Central Hospital,Liaoyang,Liaoning 111000,China)
出处
《热带医学杂志》
CAS
2022年第1期111-114,共4页
Journal of Tropical Medicine
基金
辽宁省科研基金(20180551267)
关键词
晚期乳腺癌
新辅助化疗
T淋巴细胞亚群
Advanced breast cancer
Neoadjuvant chemotherapy
T lymphocyte subset
作者简介
黄克华(1980-),男,本科,副主任医师,研究方向:普通外科,E⁃mail:lyszxyyhkh@163.com
