Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2017, Vol. 39 ›› Issue (3): 371-376.doi: 10.3881/j.issn.1000-503X.2017.03.012

• Orginal Article • Previous Articles     Next Articles

Impact of Lymphocyte Subsets on Chemotherapy Efficacy and Long-term Survival of Patients with Advanced Non-small-cell Lung Cancer

Zhimin WEI1,2, Weiqiang ZHANG2, Feng GAO2, Yunbo WU1, Guoqing ZHANG2, Zhefeng LIU1, Shunchang JIAO1()   

  1. 1Department of Medical Oncology,Chinese PLA General Hospital,Beijing 100853,China
    2Department of Health Care,Chinese PLA Joint Staff Headquarters Guard Bureau,Beijing 100017,China
  • Received:2017-05-23 Online:2017-06-30 Published:2017-06-20

Abstract:

Objective To analyze the impact of lymphocyte subsets on chemotherapy efficacy and long-term survival of patients with advanced non-small cell lung cancer(NSCLC).Methods Totally 125 NSCLC patients who had received first-line chemotherapy including paclitaxel and pemetrexed with/without platinum were enrolled in this study.Lymphocytes from peripheral blood were collected before and after two cycles of first-line chemotherapy.Flow cytometry was performed to determine the expressions of 21 fluorescence-labeled lymphocyte subsets.Based on the imaging findings,chemotherapy efficacy was evaluated,and impact of the lymphocyte subsets on progression-free survival(PFS)and overall survival(OS)were analyzed.Results The baseline peripheral lymphocyte subsets showed no significant difference among groups receiving different treatment protocols(all P>0.05).After 2 cycles of chemotherapy,the percentage of CD4+CD29+lymphocytes was(16.87±5.28)% in progressive disease group,which was significantly lower than those in complete remission+partial remission group [(22.42±7.88)%,P=0.013] and stable disease group [(21.88±6.81)%,P=0.009].The median PFS was 7.07 months and median OS was 23.00 months.Cox multivariable regression analysis showed that the percentages of HLA-DR+(HR:1.03,95%CI:1.01-1.05,P<0.001) and CD3+HLA-DR+lymphocytes (HR:1.05,95%CI:1.01-1.08,P<0.001)were positively correlated with OS.Conclusions The rise of CD4+CD29+T lymphocytes in patients after chemotherapy indicates good chemotherapy efficacy.Higher percentage of HLA-DR+and CD3+HLA-DR+lymphocytes in peripheral blood before chemotherapy predicts favorable prognosis.

Key words: lymphocyte subsets, non-small cell lung cancer, chemotherapy, long-term survival

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