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投稿时间：2024-10-21 网络发布日期：2025-03-20
投稿时间：2024-10-21 网络发布日期：2025-03-20
中文摘要: 目的 探讨免疫治疗联合化疗及立体定向放疗对非小细胞肺癌（NSCLC）脑转移患者T淋巴细胞亚群的影响。方法 前瞻性选择南京医科大学附属老年医院2022年6月至2023年12月收治的65例NSCLC脑转移患者为研究对象，均给予免疫治疗联合化疗和立体定向放疗，根据治疗效果分为疗效良好组与疗效不佳组。比较两组外周血T淋巴细胞亚群中CD3+T、CD4+T、CD8+T细胞比例和CD4+/CD8+比值。采用受试者工作特征（ROC）曲线和曲线下面积（AUC）分析T淋巴细胞亚群相关水平对NSCLC脑转移患者疗效的预测价值。结果 NSCLC脑转移患者外周血CD3+T、CD4+T细胞比例和CD4+/CD8+比值随治疗时间逐渐升高（P＜0.01）。疗效良好组的CD3+T、CD4+T细胞比例和CD4+/CD8+比值均高于疗效不佳组（P＜0.05），CD8+T细胞比例低于疗效不佳组（P＜0.01）。ROC曲线分析显示，CD3+T细胞（AUC=0.645， 95%CI：0.569~0.722）、CD4+T（AUC=0.782， 95%CI：0.643~0.921）和CD4+/CD8+比值（AUC=0.867， 95%CI：0.688~1.000）对免疫治疗联合化疗和立体定向放疗的疗效有预测价值。结论 T淋巴细胞亚群可以用来评估NSCLC脑转移患者的治疗效果。
Abstract: Objective To investigate the effects of the T lymphocyte subsets on immunotherapy combined with chemotherapy and stereotactic body radiotherapy in non-small cell lung cancer (NSCLC) patients with brain metastases.Methods A total of 65 NSCLC patients with brain metastases treated at Geriatric Hospital of Nanjing Medical University from June 2022 to December 2023 were prospectively selected as the research objects. All patients received immunotherapy combined with chemotherapy and stereotactic body radiotherapy. Based on treatment outcomes, they were divided into good efficacy group and poor efficacy group. The proportions of CD3+T, CD4+T, CD8+T cells, and the CD4+/CD8+ ratio in peripheral blood T lymphocyte subsets were compared between the two groups. The predictive value of T lymphocyte subsets for treatment efficacy in NSCLC patients with brain metastases was assessed using receiver operating characteristic (ROC) curve and area under the curve (AUC). Results The proportions of CD3+T, CD4+T cells, and the CD4+/CD8+ ratio in peripheral blood increased significantly during treatment (P＜0.01). The proportions of CD3+T, CD4+T cells, and the CD4+/CD8+ ratio were significantly higher in the good efficacy group compared to those in the poor efficacy group (P＜0.05), while the proportion of CD8+T cells was significantly lower than that in the poor efficacy group (P＜0.01). The ROC curve analysis showed that the levels of CD3+T（AUC：0.645， 95%CI:0.569-0.722）,CD4+T（AUC：0.782，95%CI:0.643-0.921）, and the CD4+/CD8+ ratio（AUC：0.867，95%CI:0.688-1.000） showed predictive value for the efficacy of immunotherapy combined with chemotherapy and stereotactic body radiotherapy. Conclusion lymphocyte subsets can be used to evaluate the therapeutic efficacy in NSCLC patients with brain metastases.
keywords: Non-small cell lung cancer Brain metastases Immunotherapy Stereotactic body radiotherapy T-lymphocyte subsets
文章编号： 中图分类号：R734.2 文献标志码：A
基金项目:
附件
| 作者 | 单位 |
| 王文卿 | 1. 南京医科大学附属老年医院检验科，江苏 南京 210009； |
| 王秀娟 | 2. 南京医科大学第四附属医院重症医学科，江苏 南京 210031 |
| 韩荣波 | 3. 南京医科大学第四附属医院肿瘤科，江苏 南京 210031 |
| 丁昊 | 4. 南京市胸科医院检验科，江苏 南京 210029 |
| Author Name | Affiliation |
| WANG Wenqing*, WANG Xiujuan, HAN Rongbo, DING Hao | *Department of Clinical Laboratory, Geriatric Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, China |
引用文本：
王文卿,王秀娟,韩荣波,等.非小细胞肺癌脑转移患者T淋巴细胞亚群与免疫治疗联合化疗及立体定向放疗的疗效关系[J].中国临床研究,2025,38(3):375-378.
王文卿,王秀娟,韩荣波,等.非小细胞肺癌脑转移患者T淋巴细胞亚群与免疫治疗联合化疗及立体定向放疗的疗效关系[J].中国临床研究,2025,38(3):375-378.