Effect of radiotherapy on lymphocytes and their subpopulations in peripheral blood in patients with acquired immune deficiency syndrome complicated with malignant tumors
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摘要:目的
探讨放射治疗对艾滋病(AIDS)合并恶性肿瘤患者放化疗前后外周血淋巴细胞的影响。
方法选取医院2017年6月-2022年6月收治的AIDS合并恶性肿瘤患者18例, 设为观察组; 非AIDS合并恶性肿瘤患者18例, 设为对照组; 健康体检者18例, 设为健康对照组。采用流式细胞术检测各组外周血CD4+、CD8+细胞比例, 计算CD4+与CD8+比值(CD4+/CD8+)。比较治疗6个月后各组肿瘤的消退情况。
结果与健康对照组比较, 对照组和观察组外周血CD4+、CD4+/CD8+降低, CD8+增高, 差异有统计学意义(P < 0.05); 与对照组比较, 观察组外周血CD8+增高, CD4+/CD8+降低, 差异有统计学意义(P < 0.05)。放疗后1个月, 观察组外周血CD8+高于对照组, 差异有统计学意义(P < 0.05)。放疗后3个月, 观察组外周血CD4+、CD4+/CD8+低于对照组, 但差异无统计学意义(P>0.05); 观察组外周血CD8+略高于对照组, 差异无统计学意义(P>0.05)。对照组组内比较, 放疗后1个月外周血CD4+/CD8+低于放疗前, CD8+高于放疗前, 差异有统计学意义(P < 0.05); 观察组各个时点两两比较, 外周血CD4+、CD8+、CD4+/CD8+的差异均无统计学意义(P>0.05)。6个月后复查CT或磁共振成像, 观察组肿瘤组织缩小或无变化者10例, 肿瘤组织增大或淋巴结转移者5例, 除淋巴结外出现新发转移灶者3例; 对照组肿瘤组织缩小或无变化者13例, 肿瘤组织增大或出现淋巴结转移者4例, 除淋巴结外出现新发转移灶者1例。观察组与对照组肿瘤消退情况比较, 差异无统计学意义(P>0.05)。
结论放射治疗对于AIDS合并恶性肿瘤患者的淋巴细胞亚群的影响与非AIDS合并恶性肿瘤患者无显著差异, 放射治疗应该更多地应用到AIDS合并恶性肿瘤患者的治疗中。
Abstract:ObjectiveTo explore the effect of radiotherapy on lymphocytes in peripheral blood before and after chemoradiotherapy in patients with acquired immune deficiency syndrome (AIDS) complicated with malignant tumors.
MethodsFrom June 2017 to June 2022, a total of 18 AIDS patients with malignant tumors in authors' hospital were selected as observation group; 18 non-AIDS patients with malignant tumors were selected as control group; 18 healthy people with physical examinations were selected as healthy control group. Flow cytometry was used to detect the cell ratios of CD4+ and CD8+ in peripheral blood in each group, and the ratio of CD4+ to CD8+ (CD4+/CD8+) was calculated. The regression of tumors after 6 months of treatment was compared between groups.
ResultsCompared with the healthy control group, the CD4+ and CD4+/CD8+ in peripheral blood in the control group and the observation group decreased significantly, while the CD8+ increased significantly (P < 0.05); compared with the control group, the CD8+ increased significantly, while the CD4+/CD8+ decreased significantly in peripheral blood in the observation group (P < 0.05). One month after radiotherapy, the CD8+ in peripheral blood in the observation group was significantly higher than that in the control group (P < 0.05). Three months after radiotherapy, the CD4+ and CD4+/CD8+ in peripheral blood in the observation group were lower than those in the control group, but there were no significant differences between two groups (P>0.05); the CD8+ in peripheral blood in the observation group was slightly higher than that in the control group, and there was no significant difference between twogroups (P>0.05). In the intragroup comparison in the control group, the CD4+/CD8+ in peripheral blood at one month after radiotherapy was significantly lower than that before radiotherapy, while CD8+ was significantly higher than that before radiotherapy (P < 0.05); there were no significant differences in CD4+, CD8+ and CD4+/CD8+ in the peripheral blood between each time point in the observation group (P>0.05). After 6 months, CT or magnetic resonance imaging was re-examined. In the observation group, there were 10 cases with reduced or no change in tumor tissue, 5 cases with increased tumor tissue or lymph node metastasis, and 3 cases with new metastatic lesions except for lymph nodes; in the control group, there were 13 cases with reduced or no change in tumor tissue, 4 cases with increased tumor tissue or lymph node metastasis, and 1 case with new metastatic lesions except for lymph nodes. There was no significant difference in regression of tumor between the observation group and the control group (P>0.05).
ConclusionThe effect of radiotherapy on the lymphocyte subpopulations in AIDS patients with malignant tumors shows no significant difference compared with those of non-AIDS patients with malignant tumors. Therefore, radiotherapy should be more frequently applied in the treatment of AIDS patients with malignant tumors.
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表 1 观察组与对照组一般临床资料比较(x±s)
组别 性别 年龄/岁 病程/年 体力状况评分 男 女 0分 1分 2分 对照组 9 9 55.50±12.81 2.39±1.14 1 6 11 观察组 10 8 56.50±12.44 2.50±1.34 2 6 10 
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表 2 各组放疗前外周血T淋巴细胞亚群水平比较(x±s)
组别 n CD4+/% CD8+/% CD4+/CD8+ 健康对照组 18 36.38±5.95 23.41±5.30 1.57±0.18 对照组 18 25.02±4.33* 27.86±3.28* 0.93±0.21* 观察组 18 21.23±6.79* 35.14±3.50*# 0.62±0.17*# 与健康对照组比较, * P < 0.05; 与对照组比较, #P < 0.05。
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表 3 2组放疗后1个月外周血T淋巴细胞亚群水平比较(x±s)
组别 n CD4+/% CD8+/% CD4+/CD8+ 对照组 18 21.28±5.80 32.85±2.77 0.66±0.18 观察组 18 19.55±5.45 37.63±5.32* 0.53±0.29 与对照组比较, * P < 0.05。
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表 4 2组放疗后3个月外周血T淋巴细胞亚群水平比较(x±s)
组别 n CD4+/% CD8+/% CD4+/CD8+ 对照组 18 24.57±6.56 30.35±4.31 0.82±0.25 观察组 18 22.67±4.36 30.72±5.72 0.74±0.21
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表 5 2组不同时点外周血T淋巴细胞亚群水平比较(x±s)
组别 时点 CD4+/% CD8+/% CD4+/CD8+ 对照组(n=18) 放疗前 25.02±4.33 27.86±3.28 0.93±0.21 放疗后1个月 21.28±5.80 32.85±2.77* 0.66±0.18* 放疗后3个月 24.57±6.56 30.35±4.31 0.82±0.25 观察组(n=18) 放疗前 21.23±6.79 35.14±3.50 0.62±0.17 放疗后1个月 19.55±5.45 37.63±5.32 0.53±0.29 放疗后3个月 22.67±4.36 33.72±5.72 0.67±0.21 与放疗前比较, * P < 0.05。
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