• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (1): 93-96.DOI: 10.3969/j.issn.1671-2587.2022.01.021

• 临床研究 • 上一篇    下一篇

术后化疗对HER2阳性老年胃癌患者外周血淋巴细胞亚群的影响*

查艳芳, 袁庆凤, 户守鑫, 黄大兵, 程民, 崔克乐   

  1. 230001 中国科学技术大学附属第一医院西区（安徽省肿瘤医院）（查艳芳,程民）; 中国科学技术大学附属第一医院（安徽省立医院）（袁庆凤,户守鑫,黄大兵,程民,崔克乐）
  • 收稿日期:2021-06-10 发布日期:2022-01-27
  • 通讯作者: 崔克乐,女,助理研究员,博士,主要从事肿瘤免疫学方向研究,（E-mail）ckele@mail.ustc.edu.cn。
  • 作者简介:查艳芳（1987-）,女,研究实习员,主要从事肿瘤免疫学方向研究,（E-mail）852686880@qq.com。
  • 基金资助:
    *本课题受安徽省自然科学基金面上项目（No.2008085MH299）、中国科学技术大学生命科学与医学部“科大新医学培育项目”（No.WK9110000086）资助

Effect of Postoperative Chemotherapy on Peripheral Blood Lymphocyte Subsets in Elderly Patients with HER2 Positive Gastric Cancer

ZHA Yan-fang, YUAN Qing-feng, HU Shou-xin, et al   

  1. West of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Cancer Hospital), Hefei 230001
  • Received:2021-06-10 Published:2022-01-27

RichHTML

7

PDF

677

摘要： 目的 明确术后辅助化疗前后老年胃癌患者外周血淋巴细胞亚群的变化,分析人类表皮生长因子受体2（HER2）在老年胃癌患者预后评估中的价值。方法 回顾性收集中国科学技术大学附属第一医院2017年1月~2019年12月收治的67例进行术后辅助化疗的胃癌患者的临床资料,分析不同年龄组HER2阳性及阴性患者化疗前后白细胞和各淋巴细胞亚群的数量变化。结果 60岁及以上胃癌患者HER2阳性率为45.2%,明显高于60岁以下患者（阳性率为12.0%）,差异具有统计学意义（P=0.003）。深入分析发现,60岁及以上胃癌患者首次化疗后,HER2阳性患者CD3+T、CD3+CD4+T及CD3+CD8+T细胞绝对数均较化疗前显著降低（P均<0.05）,且其CD3+CD8+T细胞绝对数显著低于HER2阴性患者化疗后水平。同时,CD3-CD56+NK细胞和CD4+CD25+Treg细胞在化疗前后无明显变化。而在HER2阴性患者中,化疗并不影响其淋巴细胞的数量。结论 老年（≥60岁）胃癌患者HER2阳性比例显著增加,与HER2阴性患者相比,术后辅助化疗显著抑制HER2阳性患者淋巴细胞的数量,进而影响HER2阳性患者的免疫状态,由此推测精准的免疫治疗或联合小剂量化疗比传统化疗更适用于HER2阳性的老年胃癌患者。

关键词: 胃癌术后辅助化疗, 人类表皮生长因子受体2, 外周血淋巴细胞, 年龄

Abstract: Objective We aim to clarify the changes of lymphocyte subsets in peripheral blood of elderly patients with gastric cancer before and after postoperative adjuvant chemotherapy, and to analyze the value of human epidermal growth factor receptor 2 (HER2) in the prognosis evaluation of elderly patients with gastric cancer. Methods The clinical data of 67 patients with gastric cancer who received postoperative adjuvant chemotherapy in the First Affiliated Hospital of University of Science and Technology of China from January 2017 to December 2019 were retrospectively collectedto analyze the number changes of white blood cells and lymphocyte subsets before and after chemotherapy in different age groups of HER2+ and HER2- gastric cancer patients. Results The frequency of HER2+ gastric cancer patients aged ≥60 was 45.2%, which was significantly higher than that in patients <60 years (12.0%), and the difference was significant (P=0.003). Further analysis showed that the absolute numbers of CD3+T, CD3+CD4+T and CD3+CD8+T cells in patients with gastric cancer aged≥60 years after the first chemotherapy were significantly lower than those before chemotherapy (P<0.05), and the absolute numbers of CD3+CD8+T cells in HER2+patients were significantly lower than those in HER2- patients after chemotherapy. At the same time, CD3-CD56+NK cells and CD4+CD25+Treg cells showed no significant changes before and after chemotherapy. In HER2-patients, however, chemotherapy did not affect the number of lymphocytes. Conclusion The proportion of HER2+ elderly patients (≥60 years) with gastric cancer was significantly increased. Compared with HER2- patients, adjuvant chemotherapy significantly inhibited the number of lymphocytes in HER2+patients, thus affecting the immune status of HER2+ patients. Therefore, it is speculated that precise immunotherapy or combination with low-dose chemotherapy is more suitable for elderly patients with HER2+ gastric cancer than traditional chemotherapy.

Key words: Gastric cancerPostoperative adjuvant chemotherapy, Human epidermal growth factor receptor 2, Peripheral blood lymphocytes, Age

中图分类号: