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从免疫抑制和循环肿瘤细胞探讨肺癌核心病机“正虚伏毒”的生物学基础 预览

Exploring the Biological Basis of Lung Cancer Core Pathogenesis “Declined Healthy Qi and Hidden Toxin” from the Perspective of Immune Disorders and Circulating Tumor Cell
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摘要 目的:筛选非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者转移高危因素。方法:收集70例I-IV期NSCLC患者的基本临床资料,并检测外周血中免疫细胞因子、循环肿瘤细胞的表达水平,并随访无进展生存期;分析影响无进展生存期的独立因素。结果:单因素分析显示:CTC计数与IL-6水平呈正相关(rs=0.224,P <0.05);IL-6水平(rs=-0.267,P <0.05)、sIL-2R水平(rs=-0.252,P <0.05)与PFS呈负相关;临床分期(rs=-0.304,P <0.05)与PFS呈负相关;CTC计数(rs=-0.278,P <0.05)与PFS呈负相关。根据临床检测指标的正常值范围,分成不同的亚组,结果显示IIIb-IV期患者PFS为11.00个月,与I期-IIIa期比较具有统计学意义(P <0.05);IL-6高表达组患者PFS为10.00个月,与低表达组和正常组比较差异有统计学意义(P <0.05);sIL-2R正常表达组PFS为25.00个月,sIL-2R高表达组患者PFS为8.00个月,三组之间比较具有统计学意义(P <0.05)。结论:非小细胞肺癌患者外周血中CTC计数、IL-6、sIL-2R可能是NSCLC患者预后的独立影响因子;且IL-6的表达水平与外周血中CTC计数具有正相关;初步显示外周血中的免疫抑制因素是CTC高表达的原因之一,而干预CTC将成为阻断转移的重要途径。 Objective: To select high risk factors for metastasis in patients with non-small cell lung cancer(NSCLC).Methods: The basic clinical data of 70 NSCLC patients with stage I-IV was collected. The expression levels of immune cytokines and circulating tumor cells in peripheral blood were detected, and the PFS(Progression-Free-Survival) was followed up. And the independent factors affecting progression-free survival were analyzed. Results: Univariate analysis showed that CTC count was positively correlated with IL-6 expression level(rs= 0.224, P < 0.05). IL-6 expression level,sIL-2 R expression level were negatively correlated with PFS(rs=-0.267, P < 0.05 and rs= 0.252, P < 0.05). Clinical stage was negatively correlated with PFS(rs=-0.304, P < 0.05). CTC count(rs=-0.278, P < 0.05) was negatively correlated with PFS. The patients were divided into different subgroups based on the normal range of clinical test indicators. The results showed that the mPFS of patients with stage IIIb-IV was 11.00 months, which was statistically significant compared with stage I-IIIa(P < 0.05). The PFS of the IL-6 high expression group was 10.00 months, which was significantly different from the low expression group and the normal group(P < 0.05). The PFS of the sIL-2 R normal expression group was 25.00 months, and the PFS of the sIL-2 R high expression group was 8.00 months. The comparison between the 3 groups was statistically significant(P < 0.05). Conclusion: CTC count, IL-6 and sIL-2 R in peripheral blood may be the independent prognostic factors in patients with NSCLC, and the expression level of IL-6 is positively correlated with CTC count in peripheral blood. Immunosuppressive factors in peripheral blood are one of the reasons for the high expression level of CTC. Therefore, intervention of CTC may be an important way to prevent metastasis.
作者 衣秀秀 罗斌 钱芳芳 上官文姬 阙祖俊 李和根 田建辉 Yi Xiuxiu;Luo Bin;Qian Fangfang;Shangguan Wenji;Que Zujun;Li He gen;Tian Jianhui(Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;Weifang Traditional Chinese Hospital, Weifang 261000, China;Institute of Traditional Chinese Medicine Oncology, Shanghai Institute of Traditional Chinese Medicine, Shanghai 200032, China)
出处 《世界科学技术:中医药现代化》 CSCD 北大核心 2019年第5期963-969,共7页 Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金 国家自然科学基金委员会面上项目(81774166):从免疫衰老与循环肿瘤细胞揭示肺癌发病及转移核心病机“正虚伏毒”的形成机制,负责人:田建辉 国家自然科学基金委员会青年项目(81803777):重楼皂苷诱导循环肿瘤细胞失巢凋亡抑制肺癌转移的作用及机制研究,负责人:阙祖俊.
关键词 正虚伏毒 非小细胞肺癌 免疫抑制 循环肿瘤细胞 无进展生存期 declined healthy qi and hidden toxin non-small cell lung cancer immunosuppression circulating tumorcells progression-free survival
作者简介 通讯作者:李和根,主任,博士生导师,主娶研究方向:中医药仿治恶性肿瘤临床研究;通讯作者:田建辉,主任医师,博士生导师,主要研究方向:恶性肿瘤的中西氐综合防治.
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