Immune Molecular Predictions Of Response To Chemotherapy And Prognosis In Patients With NSCLC

【Objective】To explore potential clinical characters and immune moleculars thatmay predict the efficacy of chemotherapy and the prognosis of NSCLC patientafter radical surgery. Aim to make a molecular prediction model and providetheoretical basis for individual treatment of patient with NSCLC.【Methods】Summarize clinicopathological characters,treatments parameters andsurvival data of168postoperative NSCLC patients, use IHC method to detect theexpressions of APRIL,CD3,CD4,CD8,COX-2,IL-2,IL-6,TGF-β1and TNF-α,investigate the potential relationship between these characters' expressions andpatients' prognosis. Peripheral blood T lymphocyte subsets of105cases weremeasured via direct immunofluorescent assay by flow cytometry, APRIL,COX-2,IL-2,IL-6,TGFβ-1,TNF-a genes' expression level in peripheral bloodwere measured via real-time PCR, SPSS16.0was used to analyse the potentialrelationship between these data and patients' response to firstline chemotherapy.【Results】1.168postoperative patients with stage Ⅰ-Ⅲ NSCLC were selected. Untill thedestinaion of study, there were117cases progression (69.6%) and104cases dead(61.9%).The median overall survival (OS) was35.1months. The mediandisease-free survival (DFS) was24.0months. Univariate analysis showed thatearlier T stage, N stage and TNM stage presented better OS(P＜0.05). Earlier Tstage, N stage and TNM stage presented better DFS (P＜0.05).COX regressionanalysis showed that T stage is independent predictor for OS. T stage is anindependent predictor for DFS. 2. In121postoperative patients who received adjuvant chemotherapy, female(P=0.021), non-adenocarcinoma (P=0.047), early TNM stage cancers presentedbetter OS. Earlier T stage and TNM stage cancers presented better DFS andOS(P＜0.05). COX regression analysis showed that TNM stage is an independentpredictor for DFS and OS.3. For postoperative patients, higher level of CD3,lower level of CD4presentedbetter prognosis(P＜0.05). COX regression analysis showed that CD4and IL-2levels are independent predictors for DFS and OS(P＜0.05).4. For postoperative patients who received adjuvant chemotherapy, lower level ofCD4presented better prognosis(P＜0.05). COX regression analysis showed thatCD4,CD8and IL-2levels are independent predictors for DFS and OS(P＜0.05).5. The ratio of CD45RA+T-lymphoid cell was significantly lower in the groupwith better efficacy of chemotherapy.【Conclusion】 The T stage is an effective predictor for the survival ofpostoperative NSCLC patients. The expressions of CD4and IL-2in tumor tissueswere independent predictors for DFS and OS of postoperative NSCLC patients.The TNM stage is an effective predictor for the survival of postoperative NSCLCpatients. CD4, CD8and IL-2were independent predictors for the survival ofpatients with adjuvant chemotherapy. CD45RA+T-lymphoid cell ratio is inverselyrelated to short-term curative effect of locally advanced or advanced patients.