摘要
目的:探究PD-1抑制剂对非小细胞肺癌患者Mito+ T淋巴细胞免疫代谢影响模式。方法:选取在2020-07-01至2022-08-01在青岛市中心医院接受II线单药应用免疫治疗(替雷利珠单抗200 mg q3w)的70例NSCLC癌症患者作为观察组,以及50例体健的志愿者作为对照组。利用Mito-Tracker,通过流式细胞术探究非小细胞肺癌患者T淋巴细胞免疫代谢变化,以及应用替雷利珠单抗探究对非小细胞肺癌患者T淋巴细胞免疫代谢影响模式。结果:非小细胞肺癌患者Mito+ CD3+、Mito+ CD3+ CD4+、Mito+ CD3+ CD8+计数较健康人均明显下降,差距具有统计学意义(p < 0.05)。经PD-1抑制剂治疗4周期后,T淋巴细胞线粒体损伤阳性的观察组患者Mito+ CD3+、Mito+ CD3+ CD4+、Mito+ CD3+ CD8+计数较治疗前差异无统计学意义,T淋巴细胞线粒体损伤阴性的观察组患者则较治疗前明显提高(p < 0.05),且通过应用Logistic回归对多因素分析并绘制ROC曲线,发现T淋巴细胞线粒体损伤阴性组患者Mito+ CD3+、Mito+ CD3+ CD4+、Mito+ CD3+ CD8+计数对免疫治疗疗效具有一定的预测作用。结论:PD-1抑制剂可以在一定程度上调节非小细胞肺癌患者较健康人群受损的淋巴细胞亚群,而T淋巴细胞线粒体损伤指数阴性患者拥有更佳临床受益。
Objective: To explore the effect model of PD-1 inhibitor on the immune metabolism of Mito+ T lym-phocytes in patients with non-small cell lung cancer. Methods: From July 1, 2020 to August 1, 2022, 70 NSCLC cancer patients who received second-line single drug immunotherapy (Tirelizumab 200 mg q3w) in Qingdao Central Hospital were selected as the observation group, and 50 healthy vol-unteers as the control group. Mito-Tracker was used to investigate the changes of T lymphocyte immune metabolism in patients with non-small cell lung cancer by flow cytometry, and the effect of tirelizumab on T lymphocyte immune metabolism in patients with non-small cell lung cancer. Re-sults: The Mito+ CD3+, Mito+ CD3+ CD4+, Mito+ CD3+ CD8+ counts in NSCLC patients were signifi-cantly lower than those in healthy people (p < 0.05). After 4 cycles of PD-1 inhibitor treatment, the Mito+ CD3+, Mito+ CD3+ CD4+, Mito+ CD3+ CD8+ counts in the observation group with positive T lymphocyte mitochondrial damage had no significant difference compared with those before treat-ment, while those in the observation group with negative T lymphocyte mitochondrial damage were significantly higher than those before treatment (p < 0.05). By using logistic regression to analyze multiple factors and draw ROC curve, it was found that Mito+ CD3+, Mito+ CD3+ CD4+ and Mito+ CD3+ CD8+ counts can predict the efficacy of immunotherapy. Conclusion: PD-1 inhibitor can regu-late the damaged lymphocyte subsets in NSCLC patients to a certain extent, and the patients with negative T lymphocyte mitochondrial damage index have better clinical benefits.
出处
《临床医学进展》
2023年第1期1038-1047,共10页
Advances in Clinical Medicine
