Prognostic value of peripheral blood CD 8+ T lymphocytes for stage Ⅲ-Ⅳ non-small cell lung cancer patients treated with chemoradiotherapy
10.3760/cma.j.cn113030-20200414-00180
- VernacularTitle:CD 8＋T细胞水平评价Ⅲ-Ⅳ期非小细胞肺癌放化疗预后价值
- Author:
Haojie WANG
1
;
Lixue WANG
;
Weiwei OUYANG
;
Zhu MA
;
Qingsong LI
;
Wengang YANG
;
Huiqin LI
;
Shengfa SU
;
Bing LU
Author Information
1. 贵州医科大学肿瘤学教研室 贵州医科大学附属医院/贵州省肿瘤医院胸部肿瘤科，贵阳 550004
- From:
Chinese Journal of Radiation Oncology
2020;29(10):849-854
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the changes of CD 8+ T cells in stage Ⅲ-Ⅳ non-small cell lung cancer (NSCLC) patients before and after radiochemotherapy and evaluate its clinical value in predicting survival. Methods:A total of 795 patients with stage Ⅲ-Ⅳ NSCLC who completed CD 8+ T cell testing from January 2011 to December 2017 were recruited (249 patients completed 1-3 tests within 6 months after treatment). The survival difference of patients with different levels of CD 8+ T cells and the prognostic value of the changes in the CD 8+ T cell level were analyzed. The survival analysis was performed by Kaplan- Meier method and log-rank test or univariate analysis. The multivariate survival analysis was conducted by Cox’s regression model. Results:Before treatment, the levels of CD 8+ T cells in the peripheral blood did not significantly differ among patients with different clinical factors. The survival time of stage Ⅲ NSCLC patients with CD 8+ T cell levels of<26.44% was significantly prolonged ( P=0.043). After treatment, the levels of CD 8+ T cells were significantly higher than those before treatment. The levels were similar within 1-3 months, decreased after 4-6 months but still significantly higher than those before treatment. The median survival time of patients with CD 8+ cell levels of<43.90% after treatment was 22 months, significantly longer than 16 months of those with CD 8+ cell levels of ≥43.90%( P=0.032). Stratified analysis demonstrated no significant difference in the survival time at 1 month and 2-3 months after treatment ( P>0.05), whereas the survival time significantly differed at 4-6 months ( P=0.001). The multivariate survival analysis showed that CD 8+ cell levels of<43.90% after treatment was an independent prognostic factor ( HR=0.714, P=0.031). Conclusions:The effect of CD 8+ T cells on prognosis of patients with stage Ⅲ-Ⅳ NSCLC is limited. After treatment, CD 8+ T cell levels are increased significantly. A certain increase in the CD 8+ T cell levels can prolong the survival time. The detection of CD 8+ T cell subtypes plays a more significant role.
