PD-1抑制剂派姆单抗对晚期非小细胞肺癌

T淋巴细胞亚群及NK细胞的影响

doi:10.3760/cma.j.issn.1673422X.2017.03.003

摘要/Abstract

摘要： 【摘要】目的观察晚期非小细胞肺癌（NSCLC）患者使用PD1抑制剂治疗前后T淋巴细胞亚群及自然杀伤（NK）细胞的变化及临床疗效。方法收集广州现代医院2015年1月至2016年1月的晚期NSCLC患者23例，经化疗或靶向药物治疗失败后给予6周期的PD1抑制剂治疗。采集患者治疗前后外周静脉血检测CD3+、CD4+、CD8+及NK细胞占外周血淋巴细胞的百分比。治疗后第2、4、6周期行胸部CT评价疗效。结果与治疗前相比，治疗后CD3+百分比（69.56%±7.81%∶63.91%±6.43%，t=2.679，P=0.005）、CD4+百分比（39.01%±4.98%∶36.09%±4.77%；t=2.031，P=0.024）和CD4+/CD8+（1.82±0.48∶1.49±0.32；t=2.743，P=0.004）均有所升高，差异有统计学意义。与治疗前相比，治疗后CD8+百分比（24.08%±5.13%∶26.04%±6.44%；t=1.142，P=0.130）和NK细胞百分比（22.68%±9.56%∶21.45%±10.01%；t=0.426，P=0.337）变化不大，差异无统计学意义。完成PD1抑制剂6个治疗周期时，NSCLC患者完全缓解3例、部分缓解10例、病情稳定8例、疾病进展2例。10例患者出现轻度困倦、口干、咳嗽、瘙痒、皮疹等不良反应，均可以耐受。结论PD1抑制剂可提高患者的细胞免疫功能，取得更为理想的近期疗效，且不良反应可接受，或许可为NSCLC患者的治疗带来新的希望。

关键词: 免疫抑制剂, 癌, 非小细胞肺, T淋巴细胞亚群, 治疗结果, PD1抑制剂

Abstract: ObjectiveTo observe the changes of T lymphocyte subsets and natural killer (NK) cells in patients with late stage nonsmall cell lung cancer (NSCLC) before and after treatment with PD1 inhibitor and its clinical effect. MethodsTotally 23 patients with NSCLC in Guangzhou Modern Hospital from January 2015 to January 2016 were collected. All patients were given 6 cycles of PD1 inhibitor treatment after chemotherapy or targeted drug treatment failure. Peripheral venous blood was collected before and after treatment to detect the percentage of CD3+, CD4+, CD8+ and NK cells in peripheral blood lymphocytes. The curative effects were evaluated by chest CT after treatment of 2, 4, 6 cycles. ResultsCompared with before treatment, the proportions of CD3+ (69.56%±7.81% vs. 63.91%±6.43%， t=2.679, P=0.005), CD4+ (39.01%±4.98% vs. 36.09%±4.77%, t=2.031, P=0.024) and CD4+/CD8+ (1.82±0.48 vs. 1.49±0.32, t=2.743, P=0.004) were increased after treatment, with significant differences. While compared with before treatment, the proportions of CD8+ (24.08%±5.13% vs. 26.04%±6.44%, t=1.142, P=0.130) and NK cells (22.68%±9.56% vs. 21.45%±10.01%, t=0.426, P=0.337) had little changes, with no significant differences. There were 3 patients with complete remission, 10 patients with partial remission, 8 patients with stable disease and 2 patients with progressive disease when completing 6 cycles of PD1 inhibitor treatment. Ten patients showed untoward effects such as mild sleepiness, thirst, tussis, pruritus and rash, and they were well tolerable. ConclusionPD1 inhibitor can improve the patient′s cellular immune function, and can achieve a more satisfactory shortterm efficacy and acceptable adverse reactions, which maybe bring new hopes for patients with NSCLC.

Key words: Immunosuppressive agents, Carcinoma, nonsmallcell lung, T lymphocyte subsets, Treatment outcome, PD1 inhibitor

黄德良,姚中平,张卫忠. PD-1抑制剂派姆单抗对晚期非小细胞肺癌 T淋巴细胞亚群及NK细胞的影响[J]. 国际肿瘤学杂志, 2017, 44(3): 169-172.

Huang Deliang, Yao Zhongping, Zhang Weizhong. Influence of PD1 inhibitor pembrolizumab on T lymphocyte subsets and NK cells in patients with late stage nonsmall cell lung cancer[J]. Journal of International Oncology, 2017, 44(3): 169-172.

参考文献

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PD-1抑制剂派姆单抗对晚期非小细胞肺癌 T淋巴细胞亚群及NK细胞的影响

Influence of PD1 inhibitor pembrolizumab on T lymphocyte subsets and NK cells in patients with late stage nonsmall cell lung cancer

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