Evaluation Of The Clinical Therapeutic Effect Of Patients With Non-small Cell Lung Cancer By Using The Proportion Of Peripheral Blood T Cells And NK Cells And Complement C3 And C4

Objective:This topic is to study the proportion of the peripheral blood T lymphocyte subsets(including CD8 +,CD4 + T cells)and NK cell,the expression levels of complement C3 and C4 of non-small cell lung cancer(Non-small cell lung cancer NSCLC),benign lung disease and healthy subjects,to explore its significance in the clinical evaluation and treatment of NSCLC patients,so as to provide a reference for the diagnosis,treatment and prognosis of NSCLC disease.Methods:1.Collect 85 patients with NSCLC and 80 patients with benign lung lesions in the Department of Respiratory Medicine of the Second Affiliated Hospital of Nanchang University from 2019.06 to 2019.12,and 20 healthy people who had no obvious abnormalities in the routine physical examination of our hospital’s physical examination center during the same period.All subjects have complete clinical data,and NSCLC patients have a clear histological basis.2.Before blood collection,all patients with NSCLC were not treated with anti-tumor therapy such as radiotherapy,chemotherapy,targeted therapy and immunotherapy.Before the treatment,the test subjects collected two tubes of fasting venous blood from the morning,each tube was about 5ml.3.Immunoturbidimetry was used to test the content of serum complement C3 and C4 in the three groups,and flow cytometry was used to detect the proportion of T lymphocyte subsets(including peripheral blood CD4 +,CD8 + T cells and CD4 + /CD8 + ratio)and NK cell ratio.4.To evaluate the short-term efficacy of the enrolled patients according to the RECIST1.1 standard "Evaluation Criteria for Clinical Therapeutic Efficacy of Solid Tumors",and compare the expression levels of the indicators between the effective and ineffective groups.5.Use SPSS 23.0 software for statistical analysis.Results:1.The content of serum complement C3 in NSCLC group was significantly higher than that in benign lung disease group and healthy physical examination group(P <0.05).The content of serum complement C4 in NSCLC group was higher than that in healthy physical examination group(P <0.05),compared with benign disease group in NSCLC group(P> 0.05).The measured values of CD4 + T cells in peripheral blood of NSCLC group were significantly lower than those of benign lung disease group and healthy physical examination group(P <0.05).The measured value of CD8 + T cells in NSCLC group was significantly higher than that in benign lung disease group and healthy physical examination group(P <0.05).The ratio of CD4 + /CD8 + in NSCLC group was significantly lower than that in benign lung disease group and healthy physical examination group(P <0.05).The percentage of peripheral blood NK cells in NSCLC group was significantly higher than that of benign lung disease group,while the percentage of peripheral blood NK cells in NSCLC group was significantly lower than that of healthy physical examination group(P <0.05).2.Serum complement C3 level and CD4 + / CD8 + ratio in NSCLC patients are related to age(P <0.05),and have no obvious correlation with gender,smoking history and pathological type(P> 0.05).However,the levels of complement C4,CD4+,CD8 + T cells and NK cells were not significantly related to gender,age,smoking status and pathological type(P> 0.05).3.Peripheral blood complement C3,C4,CD4 +,CD8 + T cells,NK cells and CD4 + / CD8 + ratio expression levels in NSCLC patients were not significantly correlated with lymph node metastasis(P> 0.05).4.Serum complement C3 concentration in NSCLC patients with distant metastasis is slightly lower than that in patients without metastasis,and serum complement C4 concentration in NSCLC patients with distant metastasis is slightly higher than that in patients without metastasis,but P> 0.05.Peripheral blood CD4 + T cells,CD4 + / CD8 + ratios and NK cells in NSCLC patients with distant metastasis were lower than those without metastasis(P <0.05).The measured value of peripheral blood CD8 + T cells in NSCLC patients with distant metastases was significantly higher than that in patients with non-metastatic NSCLC(P <0.05).5.Serum complement C3 and C4 were not significantly correlated with the TNM stage of NSCLC patients(P> 0.05);the peripheral blood CD4 + T cells,CD4 +/ CD8 + ratio and NK cells were significantly lower in patients with stage III-IV NSCLC In patients with stage Ⅰ-Ⅱ(P <0.05);the measured value of peripheral blood CD8 + T cells in patients with stage Ⅲ-Ⅳ NSCLC was significantly higher than that in patients with stage Ⅰ-Ⅱ(P <0.05).6.There is a positive correlation between serum complement C3 and C4(r =0.553,P = 0.001),there is a negative correlation between CD4 + T cells and CD8 + T cells(r =-0.309,P = 0.005),CD4 + There was a positive correlation between T cells and NK cells(r = 0.506,P = 0.008),and the expression levels of complement C3 and C4 were not significantly correlated with T lymphocyte subsets and the proportion of NK cells(P> 0.05).7.The measured values of CD4 + T cells,NK cells and CD4 + / CD8 + in NSCLC patients in the targeted treatment effective group were significantly higher than those in the ineffective group(P <0.05),and CD8 + T cells in the targeted treatment effective group were significantly measured Lower than the ineffective group(P <0.05);the measured value of the CD4 + / CD8 + ratio in the chemotherapy-effective group was significantly higher than the ineffective group(P<0.05);the measured values of CD4 +,CD8 + T cells,and NK cells were in There was no significant correlation between the ineffective groups(P> 0.05);there was no significant correlation between the levels of serum complement C3 and C4 expression in the effective group of chemotherapy and targeted therapy and the ineffective group(P> 0.05).Conclusions:(1)The immune function of NSCLC patients has decreased to varying degrees(expressed as increased levels of complement C3 and C4,decreased proportion of CD4 + T cells and NK cells,and increased proportion of CD8 + T cells).(2)The expression levels of C3 and C4,T lymphocyte subsets and NK cells in peripheral blood complement of NSCLC patients were not significantly correlated with gender,age,smoking status and pathological type.(3)Peripheral blood T lymphocyte subsets and NK cells may be closely relatedto the occurrence,development,invasion and metastasis of NSCLC.(4)Peripheral blood T lymphocyte subsets and NK cells are expected to be used as indicators to evaluate the short-term efficacy of NSCLC targeted therapy.