鼻咽癌放化疗治疗患者外周血PD-1及免疫指标水平的变化及其临床意义
Significance of changes of PD-1 and immune indexes in peripheral blood of patients with nasopharyngeal carcinoma treated with radio-therapy and chemotherapy
俞璐璐 1万晶 1葛宜枝 1宗丹 1师凌云1
作者信息
- 1. 江苏省肿瘤医院放疗科 江苏 南京 210009
- 折叠
摘要
目的 探讨鼻咽癌放化疗治疗患者外周血程序性死亡受体1(PD-1)及免疫指标水平的变化及其临床意义.方法 回顾性选取2020年1月至2023年江苏省肿瘤医院收治的90例鼻咽癌患者,所有患者均经病理确诊并接受放化疗治疗,采集其血液样本之后采用流式细胞术对不同时间段(治疗前、新辅助化疗后、放疗后)外周血淋巴细胞亚群比例、外周血PD-1、CD8+CD28+细胞比例的水平变化予以动态监测并比较.结果 鼻咽癌患者新辅助化疗后CD3+、CD4+细胞比例、CD4+/CD8+比值分别为(72.28±8.37)％、(39.27±8.58)％、1.58±0.67,均明显高于治疗前,CD3-CD16+CD56+、CD19+细胞比例分别为(18.27±8.38)％、(7.87±4.08)％,均明显低于治疗前,差异均有统计学意义(P＜0.05);新辅助化疗后与治疗前的CD8+细胞比例比较,差异无统计学意义(P＞0.05).鼻咽癌患者新辅助化疗之后CD8+CD28+细胞比例为(10.68±3.87)％,明显高于治疗前,差异有统计学意义(P＜0.05);新辅助化疗后与治疗前的外周血PD-1水平比较,差异无统计学意义(P＞0.05).放疗后与治疗前的CD3+细胞比例比较,差异无统计学意义(P＞0.05);鼻咽癌患者放疗后CD4+细胞比例、CD4+/CD8+比值、CD19+细胞比例 分别为(26.68±6.09)％、0.88±0.29、(3.69±2.36)％,均明显低于治疗前,CD8+、CD3-CD16+CD56+细胞比例 分别为(31.03±8.08)％、(27.39±10.26)％,均明显高于治疗前,差异均有统计学意义(P＜0.05).鼻咽癌患者放疗后CD8+CD28+细胞比例为(7.08±2.57)％,明显低于治疗前,外周血PD-1水平为(13.38±6.27)％,明显高于治疗前,差异均有统计学意义(P＜0.05).结论 新辅助化疗之后鼻咽癌患者外周血T细胞亚群比值处于持续上调趋势,而放疗完成后处于下降趋势,表明鼻咽癌患者于放疗完成后免疫功能受损;放疗完成后鼻咽癌患者T细胞PD-1表达水平明显上调,提示PD-1抑制剂最佳使用时间可能为放化疗完成时,抗PD-1维持治疗可发挥持久、高效的抗肿瘤作用.
Abstract
Objective To study the changes of programmed death-1(PD-1)and immune indexes in peripheral blood of patients with nasopharyngeal carcinoma treated with radiotherapy and chemotherapy.Methods A total of 90 patients with nasopharyngeal carcinoma admitted to Jiangsu Cancer Hospital from January 2020 to 2023 were retrospectively selected.All patients were pathologically confirmed and received radiother-apy and chemotherapy treatment.After collecting blood samples,flow cytometry was used to dynamically monitor and compare the changes of the proportion of peripheral blood lymphocyte subsets,peripheral blood PD-1,CD8+CD28+cells.in peripheral blood at different time periods(be-fore chemoradiotherapy,after neoadjuvant chemotherapy and after radiotherapy).Results After neoadjuvant chemotherapy,the proportions of CD3+,CD4+cells,CD4+/CD8+ratio in nasopharyngeal carcinoma patients were(72.28±8.37)％,(39.27±8.58)％,and 1.58±0.67,respectively,which were significantly higher than those before treatment,The proportions of CD3-CD 16+CD56+and CD19+cells were(18.27±8.38)％and(7.87±4.08)％,respectively,which were significantly lower than those before treatment,and the differences were statistically significant(P＜0.05);there was no statistically significant difference in the proportion of CD8+cells between after neoadjuvant chemotherapy and before treatment(P＞0.05).The proportion of CD8+CD28+cells in nasopharyngeal carcinoma patients after neoadjuvant chemotherapy was(10.68±3.87)％,which was significantly higher than that before treatment,and the difference was statistically significant(P＜0.05);there was no statistically significant difference in the peripheral blood PD-1 levels after neoadjuvant chemotherapy compared to before treatment(P＞0.05).There was no statistically significant difference in the proportion of CD3+cells between after radiotherapy and before treatment(P＞0.05);the proportion of CD4+cells,CD4+/CD8+ratio,the proportion of CD19+cells in nasopharyngeal carcinoma patients after radiothera-py was(26.68±6.09)％,0.88±0.29,and(3.69±2.36)％,respectively,which were significantly lower than those before treatment,the proportions of CD8+and CD3-CD 16+CD56+cells were(31.03±8.08)％and(27.39±10.26)％,respectively,which were significantly higher than those before treatment,and the differences were statistically significant(P＜0.05).Conclusion After neoadjuvant chemotherapy,the proportion of peripheral blood T cell subpopulations in nasopharyngeal carcinoma patients showed a continuous upward trend,while it showed a downward trend after radiotherapy,indicating that the immune function of nasopharyngeal carcinoma patients was impaired after radiotherapy.The expression level of PD-1 in T cells of nasopharyngeal carcinoma patients was significantly up-regulated after radiotherapy,suggesting that the best time to use PD-1 inhibitors may be when radiotherapy and chemotherapy are completed,and anti-PD-1 maintenance therapy can play a long-lasting and efficient anti-tumor effect.
关键词
鼻咽肿瘤/CD4/CD8比值/新辅助化疗/放疗/PD-1/T细胞亚群Key words
Nasopharyngeal neoplasms/CD4/CD8 ratio/Neoadjuvant chemotherapy/Radiotherapy/PD-1/T cell subpopulation引用本文复制引用
基金项目
江苏省博士后科研资助项目(200730000107)
出版年
2024
NETL
NSTL
万方数据