摘要
目的探索外周血循环淋巴细胞的基线水平及动态变化与接受表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗的EGFR突变阳性的转移性非小细胞肺癌患者预后之间的相关性。方法设计一个回顾性队列,包括在北京协和医院接受EGFR-TKI治疗的40例非小细胞肺癌患者。在EGFR-TKI治疗期间,使用流式细胞仪测量术收集外周血循环淋巴细胞亚群进行动态监测,并通过电话随访每位患者的生存情况,分别比较基线以及治疗1月后外周血循环淋巴细胞亚群与无进展生存期(PFS)和总生存期(OS)的关系。结果在接受EGFR-TKI治疗的患者中,更高的基线循环CD4^(+)CD45RA^(+)CD62L^(+)T细胞计数与更高的肿瘤治疗应答相关(P<0.001)。整个人群的PFS为27.1个月,而OS未达到。然而,基线CD4^(+)CD45RA^(+)CD62L^(+)T细胞计数与中位PFS无相关性。此外,在EGFR-TKI治疗期间,CD4^(+)CD45RA^(+)CD62L^(+)T细胞计数稳定或升高的患者的PFS明显长于CD4^(+)CD45RA^(+)CD62L^(+)T细胞计数降低的患者(29.1个月对比9.4个月;P<0.001)。结论更高的基线循环CD4^(+)CD45RA^(+)CD62L^(+)T细胞计数与更好的EGFR-TKI治疗应答相关,CD4^(+)CD45RA^(+)CD62L^(+)T细胞计数的动态变化与PFS延长有关。
Objective To explore the correlation between circulating lymphocyte profiles and the outcomes of non-small cell lung cancer(NSCLC)patients undergoing epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)therapy.Methods A retrospective cohort of 40 patients who received EGFR-TKI therapy at Peking Union Medical College Hospital was designed.Circulating lymphocyte subsets were collected using flow cytometry for dynamic monitoring during EGFR-TKI therapy.The survival of each patient was followed up by telephone call.The correlation of baseline and dynamic change of the peripheral blood circulating lymphocyte subsets and survival were further analyzed.Results Patients who responded to EGFR-TKI therapy had significantly higher baseline circulating CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts during dynamic monitoring.The median progression-free survival(PFS)for the entire population was 27.1 months;however,overall survival(OS)was not achieved.The median PFS did not differ significantly between patients with higher and lower baseline CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts.Furthermore,dynamic changes in CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts were significantly correlated with not only the response to EGFR-TKI therapy response,but also PFS.PFS of patients with stable or increased CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts during the EGFR-TKI therapy was significantly longer than that of patients with decreased CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts(29.1 months vs.9.4 months;P<0.001).Conclusions Higher baseline circulating CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts indicate a better EGFR-TKI response,and dynamic changes in CD4^(+)CD45RA^(+)CD62L^(+)T-cell counts are associated with prolonged PFS.
作者
操辰新
唐辉
耿瑞璇
郭伏平
白春梅
王颖轶
李太生
CAO Chenxin;TANG Hui;GENG Ruixuan;GUO Fuping;BAI Chunmei;WANG Yingyi;LI Taisheng(Department of Medical Oncology,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China;Department of International Medical Services,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China;Department of Infectious Diseases,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)
出处
《基础医学与临床》
CAS
2024年第5期658-664,共7页
Basic and Clinical Medicine
基金
北京协和医院中央高水平医院临床科研专项(2022-PUMCH-A-213,2022-PUMCH-A-126,2022-PUMCH-B-117)。
