CAJ | 학술논문

目的：检测非小细胞肺癌（NSCLC）患者治疗前后外周血 CD4+CD25+调节性 T 细胞（Treg）水平的变化，并研究其与癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片断（CYFRA21-1）、肿瘤特异性生长因子（TSGF）之间的相关性，探讨其在NSCLC病情监测及判断预后方面的临床应用价值。方法采用流式细胞技术检测59例NSCLC患者治疗前、治疗结束、治疗结束后3个月外周血CD4+CD25+Treg水平，并分别采用化学发光法、速率法检测CEA、NSE、CYFRA21-1、TSGF水平。结果治疗前、治疗结束、治疗结束后3个月CD4+CD25+Treg水平分别为（23.37±5.84）%、（19.42±4.03）%、（17.17±6.51）%，与CEA的相关系数分别为0.759、0.751、0.760；与CYFRA21-1的相关系数分别为0.760、0.679、0.750；与TSGF的相关系数分别为0.632、0.736、0.796（P＜0.01），与NSE则无明显相关性。近期疗效评价为CR和PR的患者在治疗结束和结束后3个月CD4+CD25+Treg水平均较PD和SD患者低[（17.97±2.47）% vs.（22.47±4.97）%，P＜0.01；（13.60±3.01）%vs.（24.68±5.40）%，P＜0.01]，治疗前水平则无显著差异[（23.79±7.67）%vs.（23.17±4.84）%，P=0.749]。结论 NSCLC患者外周血CD4+CD25+Treg水平随机体肿瘤负荷变化而变化，在NSCLC病情监测和判断预后方面具有一定的临床价值。
목적：검측비소세포폐암（NSCLC）환자치료전후외주혈 CD4+CD25+조절성 T 세포（Treg）수평적변화，병연구기여암배항원（CEA）、신경원특이성희순화매（NSE）、세포각단백19편단（CYFRA21-1）、종류특이성생장인자（TSGF）지간적상관성，탐토기재NSCLC병정감측급판단예후방면적림상응용개치。방법채용류식세포기술검측59례NSCLC환자치료전、치료결속、치료결속후3개월외주혈CD4+CD25+Treg수평，병분별채용화학발광법、속솔법검측CEA、NSE、CYFRA21-1、TSGF수평。결과치료전、치료결속、치료결속후3개월CD4+CD25+Treg수평분별위（23.37±5.84）%、（19.42±4.03）%、（17.17±6.51）%，여CEA적상관계수분별위0.759、0.751、0.760；여CYFRA21-1적상관계수분별위0.760、0.679、0.750；여TSGF적상관계수분별위0.632、0.736、0.796（P＜0.01），여NSE칙무명현상관성。근기료효평개위CR화PR적환자재치료결속화결속후3개월CD4+CD25+Treg수평균교PD화SD환자저[（17.97±2.47）% vs.（22.47±4.97）%，P＜0.01；（13.60±3.01）%vs.（24.68±5.40）%，P＜0.01]，치료전수평칙무현저차이[（23.79±7.67）%vs.（23.17±4.84）%，P=0.749]。결론 NSCLC환자외주혈CD4+CD25+Treg수평수궤체종류부하변화이변화，재NSCLC병정감측화판단예후방면구유일정적림상개치。
Objective To evaluate the proportion of CD4+CD25+regulatory T cells (Treg) in peripheral blood of patients with non-small cell lung cancer pre and post treatment and observe the relationship between CD4+CD25+Treg and CEA, NSE, CYFRA21-1 and TSGF, so as to determine the value of Treg in illness monitoring and prognosis. Methods 59 NSCLC patients according to the including criteria were selected and 4 ml of blood were drawn from the patients before treatment (0 d), on the 14th day(14 d) after treatment and 3 months(3 m) after treatment. The proportion of Treg was tested by flow cytometry. The levels of CEA, NSE and CYFRA21-1 were detected by chemiluminescence method and the level of TSGF was detected by velocity method. Results The proportions of Treg on 0 d, 14 d and 3 m were (23.37±5.84)%, (19.42±4.03)% and (17.17±6.51)%, respectively. The correlation coefficient between Treg and CEA on 0 d, 14 d and 3 m was 0.759, 0.751 and 0.760, respectively. The correlation coefficient between Treg and CYFRA21-1 was 0.760, 0.679 and 0.750, respectively. The correlation coefficient between Treg and TSGF was 0.632, 0.736 and 0.796, respectively. Treg had no correlation withNSE level. There were significant differences of Treg levels between CR+PR group and PD+SD group on 14 d and 3 m, (17.97±2.47)%vs. (22.47±4.97)%, P<0.01;(13.60±3.01)%vs. (24.68±5.40)%, P<0.01, but there was no significant differences before treatment, (23.79±7.67)% vs. (23.17±4.84)%, P=0.749. Conclusion This study suggests that the Treg level of NSCLC patients is correlated with the tumor burden and it may be used for illness monitoring and prognosis.