| Research backgroundFor patients with tumor disease changes,the abnormal serum tumor markers often can reminder the changes of the disease,expecially in patients with no significant changes in clinical symptoms and the imaging abnormalities.The recent curative effect evaluation of curative effect evaluation of solid tumor mainly according to the standard to evaluate RECIST 1.1,which mainly adopts mainly on CT and MRI imaging examination method,but the change of small lesions can’t evaluate accurately,and easily influenced by subjective factors,and can’t applied to evaluate the curative effect of targeted drugs,so sometimes this kind of evaluation method does not accurately reflect the real condition of patients condition change,and need to find new ways to solve this problem.Any abnormal tumor markers may have prompted meaning,but single abnormal serum tumor markers have certain limitation for advanced lung adenocarinoma and the immune function often have decreased on varying degrees in cancer patients.Therefore,this study choose three more valuable markers,including the immune-suppressing cell-CD4+CD25+CD127-regulatory T cell(regulatory T cell,Treg),serum tumor maker CEA(Carcinoembryonic antigen,CEA)and Carbohydrate antigen 125(Carbohydrate antigen,CA125).ObjectiveWe will detect to the expression level for the healthy and advanced lung adenocarinoma patients befor and after Pemetrexed combined with Platinum class treatments,and will discuss these three kinds of tumor markers whether the expression is different in health and advanced lung adenocarinoma patients befor and after treatments.And we will observe wheather the changes of the three kinds of tumor markers before and after treaments is consistent with disease’s efficacy assessment,and that among the tumoe markers have relevance,which provide a basis for clinical application.Methods1.This study collects the peripheral blood in the morning in patients with stage IIIB-IV unresctable lung adenocarionma for treatments before the first time and after the end of Pemetrexed combined with Platinum chemotherapy treatment 4-6 cycles,and the peripheral blood of healthy.Using the tri-color fluorescent marker flowtype cell instrument(FCM)detect that the CD4+CD25+CD127-Treg cell accounts for CD4+ cells of proportion of peripheral blood.Using the electro-chemical immune analysis method detects the level of the serum tumor markers CEA and CA125 of peripheral blood.2.Wheather the expression level of the CD4+CD25+CD127-Treg,CEA and CA125 of peripheral blood between the health people and the advanced lung adenocarionma befor treatment have a difference,and wheather this difference is related for age and gender in both groups.3.Comparing the expression level of the CD4+CD25+CD127-Treg,CEA and CA125 of peripheral blood between the advanced lung adenocarionma befor and after treatment,wheather this datas have statistical significance,and wheather the changes of this data between the advanced lung adenocarionma befor and after treatment is consistent with the recent efficacy evaluation.4.Analysising the level changes of the CD4+CD25+CD127-Treg,CEA and CA125 of peripheral blood in the advanced lung adenocarionma befor and after treatment,which is or not relevant among the CD4+CD25+CD127-Treg,CEA and CA125.5.Using the SPSS 17.0 software process these data,and the representation of measurement datas use the mean ± standard.The difference of two group uses the t – test and chi-square test,and the relevance among the three markers use the method of the Pearson correlation coefficient.P < 0.05 is said to have a statistical significance.Results:1.The age is range for 39-70 years of the healthy control group,the median age was 57 years;the age is range for 39-70 years of the advanced adenocarionma group,the median age was 56 years;The healthy control group has 11 males and 9 females;the advanced lung adenocarionma group has 25 males and 17 females.The proportion of males and females between the two group is similar.The age and gender are not statistically significant.2.For the healthy control group,the proportion of CD4+CD25+CD127-Treg cells is(3.02 ± 0.72)%,and the level of CEA is(2.37 ± 1.28)ng / ml,CA125 is(17.37 ±7.58)U / ml;The patients with advanced lung adenocarcinoma is(6.42 ± 1.57)%,CEA(31.49 ± 22.97)ng / ml,CA125(65.19 ± 26.16)U / ml.P< 0.001.These differences.have statistically significant.3.The proportion of CD4+CD25+CD127-Treg cells is(5.48 ± 1.74)% of the patients with advanced lung adenocarcinoma after treatment,compared with before treatment P = 0.02.The level of CEA is(16.34 ± 20.07)ng / ml of the patients with advanced lung adenocarcinoma after treatment,compared with before treatment,P < 0.01.The level of CA125 is(48.69 ± 38.29)U / ml of the patients with advanced lung adenocarcinoma after treatment,compared with before treatment,P = 0.03.These level of three tumor markers of the patients with advanced lung adenocarcinoma after treatment is lower than patient before treatment and the differences have statistically significant.4.After end of the treatment in patients with advanced lung adenocarcinoma,the treatment efficacy achieved CR 0 cases,15 cases reached PR,17 cases reached SD,and 10 cases reached PD,so the objective effective rate is(15/42)%,and the clinical benefit rate(CR + PR+SD)reached(32/42)%.The proportion of CD4+CD25+CD127-Treg cell is(4.81 ± 0.73)%,the level of CEA is(10.38 ± 13.09)ng/ml and the levels of CA125 is(32.90 ± 14.06)U/ml in the group of the clinical benefit rate.The proportion of CD4+CD25+CD127-Treg cell is(8.03 ± 2.38)%,the level of CEA is(35.42 ± 26.72)ng/ml and the levels of CA125 is(99.22 ± 47.69)U/ml in PD group.Three indicators of comparsion between the two group P < 0.05 the differences have statistically significant.5.The proportion of CD4+CD25+CD127-Treg cell,the level of CEA and CA125 are some positive correlation in patients with Advanced Lung adenocarcinoma before and after treatment,in which CD4+CD25+CD127-Treg cell with CEA r = 0.71 and with CA125 r = 0.70 in patient before treatment;CD4+CD25+CD127-Treg cell with CEA r = 0.77 and with CA125 r = 0.76 in patient after treatment.Conclusion:Advanced lung adenocarcinoma patients CD4 + CD25 + CD127 Treg cells,CEA and CA125 levels in peripheral blood have a certain relationship with the occurrence and development of lung cancer,so they can be used as index of clinical auxiliary diagnosis of lung adenocarcinoma.CD4+CD25+CD127-Treg cell will rise with the tumor load increasing,therefore the body’s immune inhabition will strengthen.Meanwhile,research find that CD4+CD25+CD127-Treg cells,CEA and CA125 can serve as a predictive markers of diagnostic and the therapeutic effort,and also proved that the pemetrexed combined platinum validity on the application of the patients with advanced lung adenocarcinoma.Three indicators are very important for determining the disease changes,for the relationship between the disease changes and efficacy evaluation,with regard to immune function of guidance and treatment. |
PDF Full Text Request