【摘要】 目的:评估周围型肺癌胸水T细胞亚群定量分析对生存时间的预测价值。方法:研究收集本院就诊且接受手术治疗的周围型肺癌患者(n=48)纳入本次研究作为试验观察组受试对象,病例收集时间为2015年3月～2019年3月;同期选取并接受其他开胸手术治疗的胸外科疾病(非肺癌)患者作为对照组(n=48),于术中留取患者的胸水脱落细胞液样本。分别于治疗前、治疗后,无菌环境下采集患者外周血,采用流式细胞仪检测淋巴细胞亚群及其组分比例分析。分别于治疗前、治疗后,采用欧洲癌调查治疗组织生存质量中心调查表评价患者的生活质量。于治疗后根据RECIST标准(Response Evaluation Criteria in Solid Tumors)对治疗效果进行评价,根据影像学检查结果分为完全缓解(Complete remission,CR)、部分缓解(Partial remission,PR)、病变稳定(Stable disease,SD)和疾病进展(Progression disease,PD),以CR+PR为临床有效,CR+PR+SD为临床受益,计算临床有效率以及临床受益率等指标。结果:研究中观察组与对照组的受试患者临床受益率在观察组明显更高。治疗前患者CD3+、CD4+、CD8+、CD4+/CD8+水平充分可比,治疗后,两组患者CD3+、CD4+、CD4+/CD8+均较治疗前明显升高,CD8+明显降低,差异均具有统计学意义;治疗后,试验组患者CD3+、CD4+、CD4+/CD8+明显更高,CD8+则显著更低。治疗前,两组患者EORTCQOL-C30评分比较,差异均无统计学意义;治疗后,试验组患者EORTCQOL-C30评分明显高于对照组患者,差异具有统计学意义。此处采用H检验对影响患者中位生存时间的因素进行比较,结果显示,年龄、吸烟年限(年)、吸烟量(支/周)、周围型肺癌胸水T细胞亚群定量分析结果均为周围型肺癌患者生存时间的相关因素。结论:周围型肺癌胸水T细胞亚群定量分析对生存时间具有较为优质的临床预测价值。更多还原

【Abstract】 Objective To evaluate the predictive value of quantitative analysis of pleural fluid T cell subsets in peripheral lung cancer for survival time.Methods From March 2015 to March 2019,a group sampling method was used to continuously collect peripheral lung cancer patients (n=48) who were registered and admitted to a tertiary hospital and received surgical treatment.At the same time,other chest surgery was selected and accepted.Patients with treated thoracic surgery disease (non-lung cancer) were used as the control group (n=48),and pleural fluid exfoliated cell fluid samples were taken during the operation.The peripheral blood of patients was collected before and after treatment in a sterile environment,and the lymphocyte subgroups and their component ratios were analyzed by flow cytometry.Before and after treatment,the quality of life of patients was evaluated by using the questionnaires of the European Cancer Survey and Treatment Tissue Quality of Life Center.After treatment,the treatment effect was evaluated according to the RECIST standard (Response Evaluation Criteria in Solid Tumors).According to the results of imaging examination,it was divided into complete remission (CR),partial remission (PR),and stable disease (Stable disease).,SD) and Progression disease (PD),CR + PR is clinically effective,CR + PR + SD is clinical benefit,and clinical effectiveness and clinical benefit rate are calculated.Results There was no significant difference in clinical effectiveness between the two groups.The clinical benefit rate was significantly higher in the observation group than in the control group.Before treatment,there was no significant difference in CD3 +,CD4 +,CD8 +,CD4 + / CD8 + between the two groups.After treatment,CD3 +,CD4 +,CD4 + / CD8 + in the two groups were significantly higher than before treatment.CD8 + decreased significantly,and the differences were statistically significant.After treatment,patients in the experimental group had significantly higher CD3 +,CD4 +,and CD4 + / CD8 + than those in the control group,and CD8 + was significantly lower than those in the control group.The differences were statistically significant.Before treatment,there was no significant difference in the EORTCQOL-C30 score between the two groups.After treatment,the EORTCQOL-C30 score of the test group was significantly higher than that of the control group,and the difference was statistically significant.Here,the H test is used to compare the factors that affect the median survival time of patients.The results show that the quantitative analysis results of T cell subsets of pleural effusion in peripheral lung cancer are all related to age,number of years of smoking (years),number of cigarettes (branch / week),and peripheral lung cancer.Related factors of survival time in patients with type 2 lung cancer.Conclusion Quantitative analysis of pleural effusion T cell subsets in peripheral lung cancer is of good clinical predictive value for survival time.更多还原