Effect of CD 4+ T cells and CD 4+/CD 8+ in peripheral blood on survival of patients with stage Ⅳ non-small cell lung cancer—Establishment of a Nomogram prediction model
10.3760/cma.j.cn113030-20200329-00143
- VernacularTitle:外周血CD 4＋T细胞水平及CD 4＋/CD 8＋比值对Ⅳ期非小细胞肺癌生存影响
- Author:
Lixue WANG
1
;
Haojie WANG
;
Weiwei OUYANG
;
Wengang YANG
;
Zhu MA
;
Qingsong LI
;
Huiqin LI
;
Xiaxia CHEN
;
Xiaoyang LI
;
Yichao GENG
;
Shengfa SU
;
Bing LU
Author Information
1. 贵州医科大学肿瘤学教研室 550004；贵州医科大学附属医院/贵州省肿瘤医院胸部肿瘤科 550004
- From:
Chinese Journal of Radiation Oncology
2020;29(9):751-756
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the possibility of CD 4+ T cells and CD 4+ /CD 8+ ratio in peripheral blood to predict the survival of patients with stage Ⅳ non-small cell lung cancer (NSCLC), and to establish a Nomogram prediction model. Methods:The influence of CD 4+ T cells and CD 4+ /CD 8+ ratio on the clinical factors and survival of 682 patients pathologically diagnosed with stage Ⅳ NSCLC with no history of cancer treatment was retrospectively analyzed and the Nomogram prediction model was established. Combined with the changes of immune cells levels in 110 patients after treatment, the prognostic and predictive values of CD 4+ T cells and CD 4+ /CD 8+ ratio were verified. Countable data were analyzed by t-test. The survival rate was calculated by Kaplan-Meier method, log-rank test or univariate analysis. The multivariate analysis was performed by Cox regression model. Results:Univariate analysis demonstrated that CD 4+ > 43.15% before treatment significantly prolonged the survival. By multivariate analysis of Cox regression model, CD 4+ >43.15% was an independent prognostic factor to prolong survival for stage Ⅳ NSCLC. The Nomogram model was established and verified that the predicted and actual overall survivals were highly consistent. Further analysis showed that 43.15% as the critical value of CD 4+ T cell level significantly prolonged survival when CD 4+ expressed at a high-level before treatment, after treatment, before and after treatment, or combined with CD 4+ /CD 8+ >1.65. Conclusions:The baseline level of CD 4+ T cells before treatment in peripheral blood is an independent prognostic factor for stage Ⅳ NSCLC. The CD 4+ /CD 8+ ratio before treatment has limited value in predicting the prognosis.
