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目的:观察表皮生长因子酪氨酸激酶抑制药(EGFR-TKIs)对非小细胞肺癌(NSCLC)患者外周血T淋巴细胞亚群影响及其疗效、安全性。方法:选取我院NSCLC住院患者35例为观察组,另选同期体检健康者28例为正常对照组。所有NSCLC患者均存在EGFR基因突变,并接受EGFR-TKIs治疗。于治疗前1周,治疗1,2,4周期后采用流式细胞仪检测患者T细胞亚群水平,包括CD 3~+、CD 4~+、CD 8~+、CD 4~+/CD 8~+、NK淋巴细胞数,并评价疗效及安全性。结果:治疗前,NSCLC患者CD3~+、CD 4~+、CD 4~+/CD 8~+、NK淋巴细胞均较正常对照组明显下降(P<0.01),CD 8~+淋巴细胞则显著升高(P<0.01)。治疗1,2,4周后,患者CD 4~+、CD 4~+/CD 8~+较治疗前均有不同程度升高(P<0.01),CD 8~+较治疗前明显下降(P<0.01);治疗2,4周期后,NK细胞较治疗前有不同程度升高(P<0.05);治疗4周期后,CD 3~+细胞明显高于治疗前(P<0.01)。EGFRTKIs治疗效果不同的患者间T淋巴细胞免疫功能功能的差异有统计学意义(P<0.05),淋巴细胞亚群改善情况表现为PR>SD>PD。EGFR-TKIs引起的不良反应较轻微,对症处理后均能得到缓解。结论:EGFR-TKIs可以调节NSCLC患者T淋巴细胞亚群表达,改善患者免疫功能,且安全性好。
Objective: To observe the effect of epidermal growth factor tyrosine kinase inhibitor (EGFR-TKIs) on peripheral blood T lymphocyte subsets and its efficacy and safety in patients with non-small cell lung cancer (NSCLC). Methods: Totally 35 inpatients with NSCLC in our hospital were selected as the observation group and 28 healthy subjects in the same period were selected as the normal control group. All NSCLC patients have EGFR gene mutations, and receive EGFR-TKIs treatment. The levels of T lymphocyte subsets were detected by flow cytometry, including CD 3 ~ +, CD 4 ~ +, CD 8 ~ +, CD 4 ~ + / CD 8 ~ +, NK lymphocytes, and evaluate the efficacy and safety. Results: Before treatment, the levels of CD3 +, CD 4 +, CD 4 + / CD 8 +, and NK lymphocytes in NSCLC patients were significantly lower than those in normal controls (P <0.01) Increased (P <0.01). The levels of CD 4 ~ + and CD 4 ~ + / CD 8 ~ + in patients after treatment for 1, 2 and 4 weeks were significantly higher than those before treatment (P <0.01), while the levels of CD 8 + <0.01). After treated for 2 and 4 cycles, NK cells increased to some extent (P <0.05). After 4 cycles, the number of CD 3 + cells was significantly higher than that before treatment (P <0.01). The difference of T lymphocyte immune function between patients with different EGFRTKIs treatment effect was statistically significant (P <0.05). The improvement of lymphocyte subsets was PR> SD> PD. Adverse reactions caused by EGFR-TKIs are mild, symptomatic treatment can be alleviated. Conclusion: EGFR-TKIs can regulate the expression of T lymphocyte subsets in patients with NSCLC and improve the immune function of patients with good safety.