全胸腔镜手术对肺癌病人的肿瘤标志物神经元特异烯醇化酶、降钙素原、CD3+、CD4+和CD8+的影响

doi:10.3969/j.issn.1005-6483.2021.02.012

摘要/Abstract

摘要： 目的：探讨全胸腔镜手术对肺癌病人神经元特异烯醇化酶(neuronspecific enolase，NSE)、降钙素原(procalcitonin，PCT)、CD3+、CD4+和CD8+的影响及与预后的相关性。方法：2016年10月～2018年2月我院行全胸腔镜手术的肺癌病人85例为观察组；同期来我院进行检查的102例健康人为对照组。采用电化学免疫发光法检测观察组病人手术前后以及对照组血清NSE和PCT水平，采用全自动流式细胞仪检测观察组病人手术前后及对照组CD3+、CD4+和CD8+水平。结果：观察组病人手术前后NSE、PCT水平均高于对照组，但与术前比较，术后NSE、PCT水平均显著降低，差异有统计学意义(P＜0.05)；观察组病人手术前后CD8+比例均高于对照组，而CD3+、CD4+和CD4+/CD8+比例低于对照组，与术前比较，术后病人CD3+、CD4+和CD4+/CD8+比例均显著升高，差异有统计学意义(P＜0.05)。二分类Logistic回归分析表明，NSEOR=3.32，95%CI=1.88~6.02，P=0.023)，PCT(OR=8.12，95%CI=3.25~20.12，P=0.012)，CD3+(OR=2.33，95%CI=1.52~7.92，P=0.021)，CD4+(OR=5.53，95%CI=3.20~8.65，P=0.018)和CD4+/CD8+(OR=4.82，95%CI=1.57~8.51，P=0.015)是影响肺癌病人全胸腔镜手术预后的独立危险因素。结论：全胸腔镜手术可降低病人NSE和PCT水平，改善术后免疫功能。监测术后NSE、PCT、CD3+、CD4+和CD8+水平，对评估病人预后具有重要作用。

关键词: 全胸腔镜手术, 肺癌, 神经元特异烯醇化酶, 降钙素原, 免疫功能

Abstract: Objective：To investigate the effects of total thoracoscopic surgery on tumor specific neuron specific enolase(NSE),procalcitonin(PCT),immune markers CD3+,CD4+ and CD8+ in lung cancer patients and their correlation with prognosis.Methods：A total of 85 patients with lung cancer who underwent total thoracoscopic surgery in our hospital from October 2016 to February 2018 were selected as the observation group.102 healthy people who were enrolled in our hospital for the same period were selected as control group.The levels of serum NSE and PCT in the observation group before and after operation and in the control group were measured by electrochemiluminescence method.The levels of CD3+,CD4+ and CD8+ in the observation group before and after operation and in the control group were detected by automatic flow cytometry.Results：The NSE and PCT levels in the observation group were significantly higher than those in the control group before and after surgery,while the NSE and PCT levels after operation were significantly lower than those before surgery(P＜0.05).The proportion of CD8+ before and after operation was significantly higher than that of the control group,while the proportions of CD3+,CD4+ and CD4+/CD8+ were significantly lower than those of the control group.Compared with preoperative,the proportions of CD3+,CD4+,and CD4+/CD8+ were significantly increased after surgery(P＜0.05).The logistic regression analysis showed that NSE(OR=3.32,95%CI=1.88~6.02,P=0.023),PCT(OR=8.12,95%CI=3.25~20.12,P=0.012),CD3+(OR=2.33,95%CI=1.52~7.92,P=0.021),CD4+(OR=5.53,95%CI=3.20~8.65,P=0.018) and CD4+/CD8+(OR=4.82,95%CI=1.57~8.51,P=0.015) were independent risk factor for the prognosis of lung cancer patients undergoing thoracoscopic surgery.Conclusion：The total thoracoscopic surgery can effectively reduce the levels of NSE and PCT,improve postoperative immune function,and monitor the levels of NSE,PCT,CD3+,CD4+ and CD8+ after operation has an important role in assessing the prognosis of lung cancer.

Key words: total thoracoscopic surgery, lung cancer, neuronspecific enolase, procalcitonin, immune function

陈宇, 方汉林, 刘闻. 全胸腔镜手术对肺癌病人的肿瘤标志物神经元特异烯醇化酶、降钙素原、CD3+、CD4+和CD8+的影响[J]. 临床外科杂志, 2021, 29(2): 140-142.

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