Relationship between peripheral blood T lymphocyte subsets early inflammatory markers and the prognosis in elderly patients with non-small cell lung cancer after chemotherapy

doi:10.3877/cma.j.issn.2095-1221.2020.02.005

Abstract

Abstract:

Objective

To evaluate the effect of T lymphocyte subsets and early inflammatory markers on the prognosis of elderly patients with non-small cell lung cancer (NSCLC) after chemotherapy.

Methods

86 elderly patients with non-small cell lung cancer received chemotherapy in our hospital from January 2015 to December 2018 and 82 healthy people were selected as control group. The distribution differences of T lymphocyte subsets and inflammatory cells in peripheral blood between NSCLC patients and control group were analyzed. Kaplan-Meier univariate survival analysis was performedto analyze the survival of paitents, and Cox proportional regression risk model was used to analyze the independent factors affecting the prognosis of NSCLC patients.

Results

Compared with the control group, the level of CD3⁺ (71.31±6.02 vs 68.22±7.09) , CD4⁺ (40.20±5.79 vs 36.61±7.11) , CD4⁺/ CD8⁺ (1.49±0.37 vs 1.30±0.56) , and CD8⁺ (28.43±6.37 vs 31.79±9.88) were significantly lower in NSCLC patients, while the level of PLT (229.73±58.84 vs 211.32±54.18) , absolute lymphocyte value (LY) (1.67±0.61 vs 30.01±8.45) , and percentage of lymphocyte (LY ﹪) (25.65 ﹪± 6.87 ﹪ vs 30.01 ﹪± 8.45 ﹪) were higher (t = 3.038, 3.579, 2.582, 2.606, 2.107, 3.608, 3.659, P < 0.05) . The patients with CD8⁺ T cells ≥ 31.8﹪, CD4 / CD8 < 1.28, NLR < 3.16 and PLR < 197 have longer survival time than those with TNM (P < 0.05) . In addition, the results of Cox analysis showed that distant metastasis (HR = 9.310) , TNM stage IIIB-IV (HR =1.059) , CD8⁺ T cell < 31.8﹪, NLR ≥ 3.16 (HR = 1.887) and PLR ≥ 197 (HR = 2.869) were independent factors of prognosis inelderly NSCLC patients (P < 0.05) .

Conclusion

Peripheral blood CD8⁺ T cells, CD4 / CD8 ratio, NLR and PLR levels are independent factors of prognosis inelderly patients with NSCLC, and could be used as a simple biomarker to evaluate the prognosis of elderly patients with NSCLC after chemotherapy.

Key words: T lymphocyte subsets, Early inflammatory markers, Non-small cell lung cancer, Chemotherapy, Prognosis

Yanlin Tang, Feng Wang, Zigang Liu, Yuan He. Relationship between peripheral blood T lymphocyte subsets early inflammatory markers and the prognosis in elderly patients with non-small cell lung cancer after chemotherapy[J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2020, 10(02): 97-102.

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References 20

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分组	例数	CD3⁺	CD4⁺	CD8⁺	CD4⁺/CD8⁺	NEUT（×10⁹/L）	LY（×10⁹/L）	MONO（×10⁹/L）	PLT（×10⁹/L）	LY ﹪
对照组	82	71.31±6.02	40.20±5.79	28.43±6.37	1.49±0.37	4.20±1.35	1.67±0.61	0.51±0.23	211.32±54.18	25.65±6.87
NSCLC组	86	68.22±7.09	36.61±7.11	31.79±9.88	1.30±0.56	4.01±1.28	2.03±0.88	0.52±0.22	229.73±58.84	30.01±8.45
t值	?	3.038	3.579	2.606	2.582	0.936	3.068	0.288	2.107	3.659
P值	?	0.003	< 0.001	0.010	0.011	0.350	0.003	0.774	0.037	< 0.001

分组	例数	CD3⁺	CD4⁺	CD8⁺	CD4⁺/CD8⁺	NEUT（×10⁹/L）	LY（×10⁹/L）	MONO（×10⁹/L）	PLT（×10⁹/L）	LY ﹪
对照组	82	71.31±6.02	40.20±5.79	28.43±6.37	1.49±0.37	4.20±1.35	1.67±0.61	0.51±0.23	211.32±54.18	25.65±6.87
NSCLC组	86	68.22±7.09	36.61±7.11	31.79±9.88	1.30±0.56	4.01±1.28	2.03±0.88	0.52±0.22	229.73±58.84	30.01±8.45
t值	?	3.038	3.579	2.606	2.582	0.936	3.068	0.288	2.107	3.659
P值	?	0.003	< 0.001	0.010	0.011	0.350	0.003	0.774	0.037	< 0.001

项目	例数	中位生存时间（月）	χ²值	P值
性别	?	?	0.727	0.394
男	56	20.40	?	?
女	30	36.20	?	?
年龄	?	?	0.302	0.582
≥65岁	59	16.80	?	?
< 65岁	27	28.10	?	?
吸烟史	?	?	0.479	0.489
是	49	20.40	?	?
否	37	36.20	?	?
淋巴转移	?	?	11.751	< 0.001
是	58	20.40	?	?
否	28	48.10	?	?
远处转移	?	?	10.394	< 0.001
是	33	17.10	?	?
否	53	38.90	?	?
病理类型	?	?	3.379	0.185
鳞癌	35	28.10	?	?
腺癌	42	28.00
其他	9	17.00
TNM分期	?	?	12.534	< 0.001
Ⅰ-ⅢA	34	47.70	?	?
ⅢB-Ⅳ	52	18.50	?	?

项目	例数	中位生存时间（月）	χ²值	P值
性别	?	?	0.727	0.394
男	56	20.40	?	?
女	30	36.20	?	?
年龄	?	?	0.302	0.582
≥65岁	59	16.80	?	?
< 65岁	27	28.10	?	?
吸烟史	?	?	0.479	0.489
是	49	20.40	?	?
否	37	36.20	?	?
淋巴转移	?	?	11.751	< 0.001
是	58	20.40	?	?
否	28	48.10	?	?
远处转移	?	?	10.394	< 0.001
是	33	17.10	?	?
否	53	38.90	?	?
病理类型	?	?	3.379	0.185
鳞癌	35	28.10	?	?
腺癌	42	28.00
其他	9	17.00
TNM分期	?	?	12.534	< 0.001
Ⅰ-ⅢA	34	47.70	?	?
ⅢB-Ⅳ	52	18.50	?	?

项目		例数	中位生存时间（月）	χ²值	P值	项目		例数	中位生存时间（月）	χ²值	P值
CD3⁺T（﹪）		?	?	?	?	NLR		?	?	?	?
?	≥68.4	46	25.90	0.628	0.428	?	≥3.16	33	17.10	10.394	<0.001
?	<68.4	40	27.00	0.628	0.428	?	<3.16	53	38.90	10.394	<0.001
CD4⁺T（﹪）		?	?	?	?	PLR		?	?	?	?
?	≥36.5	46	25.80	0	0.992	?	≥197	46	18.50	12.028	<0.001
?	<36.5	40	27.00	0	0.992	?	<197	40	46.10	12.028	<0.001
CD8⁺T（﹪）		?	?	?	?	LMR		?	?	?	?
?	≥31.8	41	36.20	6.681	0.010	?	≥3.6	58	28.80	0.477	0.490
?	<31.8	45	20.00	6.681	0.010	?	<3.6	28	20.70	0.477	0.490
CD4/CD8		?	?	?	?	?	?	?	?	?	?
?	≥1.28	38	20.00	4.463	0.035	?	?	?	?	?	?
?	<1.28	48	30.80	4.463	0.035	?	?	?	?	?	?

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