回顾性分析中晚期非小细胞肺癌患者化疗前后淋巴细胞亚群表达差异，以及与化疗疗效的相关性。

选择2014年1月至2018年6月在我院进行化疗治疗的中晚期非小细胞肺癌患者122例作为病例组，同期在我院进行健康体检64例作为对照组，对比分析各组T淋巴细胞亚群CD3⁺(%)、CD8⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺细胞比值差异。

病例组化疗前及后的CD3⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺细胞比值均显著低于对照组(P<0.05)；化疗后CD3⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺细胞比值均较化疗前有显著升高(P<0.05)；化疗前后病例组患者CD8⁺(%)略高于对照组，但差异未发现统计学意义(P>0.05)，且化疗前后CD8⁺(%)对比，差异未发现统计学意义(P>0.05)。化疗治疗后，将病例组分为疾病控制组共90例(73.77%)，其中完全缓解(CR)0例，部分缓解(PR)25例(20.49%)，疾病稳定(SD)65例(53.28%)；疾病进展(PD)32例(26.23%)。疾病控制组的年龄、性别与疾病进展组对比，差异无统计学意义(P>0.05)。疾病控制组治疗前CD3⁺(%)、CD4⁺(%)、CD8⁺(%)、CD4⁺/CD8⁺与疾病进展组对比，差异均无统计学差异(P>0.05)，疾病控制组治疗后CD3⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺显著高于疾病进展组，差异均具有统计学意义(P<0.05)。DCR和PD两组治疗后CD3⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺细胞比值均显著高于治疗前。两组治疗后CD8⁺(%)对比，差异无统计学意义(P>0.05)。治疗后CD3⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺水平在预测非小细胞肺癌患者化疗效果的AUC面积分别为：0.789、0.823、0.758。通过最大约登指数计算得出CD3⁺(%)、CD4⁺(%)、CD4⁺/CD8⁺指标的最大AUC面积相应参数截止值，其中CD3⁺(%)截止值为65.95(%)(敏感度＝83.30%，特异性＝78.60%，P＝0.021)，CD4⁺(%)截止值为39.81(%)(敏感度＝87.30%，特异性＝85.20%，P＝0.034)，CD4⁺/CD8⁺截止值为1.250(敏感度＝81.20%，特异性＝76.70%，P＝0.017)。

中晚期非小细胞肺癌患者的T淋巴细胞比例显著降低，细胞免疫功能呈现紊乱状态。化疗治疗的效果可能与机体外周血T淋巴细胞表达状态有关，提示肺癌患者的外周血T淋巴细胞亚群表达状态可能成为预测化疗临床效果的一种标记物。

To analyze the expression of lymphocyte subsets in the patients with advanced non-small cell lung cancer (NSCLC) before and after chemotherapy.

A total of 122 patients with advanced NSCLC who received chemotherapy in our hospital from January 2014 to June 2018 were selected as the study subjects (case group) and 64 healthy volunteers were taken as the control group during the same period. The differences of T lymphocyte subsets CD3⁺ (%), CD8⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ cell ratio in each group were compared and analyzed.

The cell ratios of CD3⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ in the case group before and after chemotherapy were significantly lower than those of the control group (P<0.05). The cell ratios of CD3⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ cells in the case group after chemotherapy were significantly higher than those before chemotherapy (P<0.05). The cell ratios of CD8⁺ (%) in the case group before and after chemotherapy were slightly higher than those of the control group, but no significant difference was found (P>0.05). And there was no significant difference in CD8⁺ (%) between the two groups (P>0.05). After chemotherapy, the case group was divided into a disease control group (n=90, 73.77%), which included complete remission (CR) in 0 case, partial remission (PR) in 25 cases (20.49%) and disease stability (SD) in 65 cases (53.28%), and a disease progression group (n=32, 26.23%). There was no significant difference in age and sex between the disease control group and the disease progression group (P>0.05). CD3⁺ (%), CD4⁺ (%), CD8⁺ (%) and CD4⁺ /CD8⁺ in the disease control group had no significant difference compared with the disease progression group before treatment (P>0.05). CD3⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ in the disease control group were significantly higher than those in the disease progression group after treatment (P<0.05). The cell ratios of CD3⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ in both groups after treatment were significantly higher than those before treatment. There was no significant difference in CD8⁺ (%) between the two groups after treatment (P>0.05). After treatment, the areas under curves (AUCs) of CD3⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ in predicting the effect of radiotherapy and chemotherapy in NSCLC patients were 0.789, 0.823 and 0.758, respectively. The cut-off values of the maximum AUCs for CD3⁺ (%), CD4⁺ (%) and CD4⁺ /CD8⁺ were calculated by maximum Yoden index. The cut-off value of CD3⁺ (%) was 65.95% (sensitivity=83.30%, specificity=78.60%, P=0.021), CD4⁺ (%) was 39.81% (sensitivity=87.30%, specificity=85.20%, P=0.034), and CD4⁺ /CD8⁺ was 1.250 (sensitivity=81.20%, specificity=76.70%, P=0.017).

The proportion of T lymphocytes in the patients with advanced NSCL is significantly reduced and the cellular immune function is disordered. The effect of chemotherapy may be related to the expression of T lymphocytes in the peripheral blood of the patients with lung cancer, suggesting that the expression of T lymphocyte subsets in the peripheral blood of the patients with lung cancer may be taken as a marker for predicting the clinical effect of chemotherapy.