摘要
研究细胞免疫功能与非小细胞肺癌（ＮＳＣＬＣ唯手术综合治疗预后的关系。从１９９２年１月至１９９４年１２月，对２６６例接受放疗和化疗综合治疗的非小细胞肺癌患者检测周围血Ｔ淋巴细胞亚群，经４年随访，采用Ｋａｐｌａｎ—Ｍｅｉｅｒ生存曲线经Ｌｏｇ—ｒａｎｋ检验，比较细胞免疫功能尚好组（Ｔ４／Ｔ８≥１）与较差组（Ｔ４／Ｔ８＜１）患者的 １年、２年和３年肿瘤局部控制率、无远处转移率和生存率。结果：非小细胞肺癌患者的细胞免疫功能较正常人明显低下（＜０．０１）；Ｔ４／Ｔ８≥ｌ和Ｔ４／Ｔ８＜ｌ两组的肿瘤局控率无明显差异（Ｐ＝０．２４５）；但前者的肿瘤无远处转移率和生存率显著优于后者（Ｐ＝０．００９和Ｐ＝０．００５）。结论：细胞免疫状态对非小细胞肺癌的治疗效果密切相关，良好的免疫功能可能通过抑制肿瘤的远处转移而提高患者的生存率。
PURPOSE The aim of the clinical trial was to find out whether or not cellular immunity status predicts the prognosis of the patients with non-small cell lung cancer (NSCLC) treated by combined radiotherapy and chemotherapy. METHODS From January 1992, the T cell subsets of 266 cases were measured by single clone flow cytometry, and all patients have been followed up for 4 years. The l, 2, 3 year tumor region control rates, free distant metastasis rates and survival rates of these patients were analyzed by Kaplan-Meter survival curves. RESULTS The results indicated that the count of T4 lymphocytes were markedly depressed (P< 0.05) and the T8 lymphocytes were markedly raised (P< 0.01), so the ratio of T4 / T8 dropped sharply in the patients than that in normal one (P< 0.01). When we divided the patients into two groups, the T4 / T8≥ １ group as cellular immunity in better condition and the T4 / T8 < 1 group in poor condition, the Kaplan-Meier survival curves showed that although there was no significant difference in statistics on the tumor control rates between two groups (P= 0.245), the 1,2,3 year free distant metastasis rates and survival rates of the T4 / T8≥1 group patients were markedly raised than that of T4 / T8 < 1 group (P = 0.009 and P = 0.005). CONCLUSIONS These data suggest that the cellular immunity was related to therapeutic prognosis of non-operable NSCLC, a good immunity status could decrease tumor distant metastasis, so that to raise the patient survival time.
出处
《上海医科大学学报》
CSCD
1997年第1期27-29,44,共4页
Journal of Fudan University(Medical Science)
关键词
肺肿瘤
非小细胞肺癌
T细胞亚群
预后
NSLC
non-small cell lung cancer
cellular immunity
non-operabletherapy
prognostic factor
