Background: The main type of treatment of unresectable NSCLC is chemoradiotherapy, which has a relatively high toxicity. One option allowing to reduce the toxicity of this approach may be immunocorrective therapy. The appointment of this type of treatment should be warranted in terms of patient’s immune system response. This confirms the importance of verifying systemic immune disorders in primary patients with NSCLC. Goal: To assess the features of the population of immune cells in peripheral blood in patients with stage IIIB, IIIC primary NSCLC and to identify any signs of secondary immunodeficiency in this cohort. Methods: We analyzed the frequencies of circulating T cells (CD3+, CD4+, CD8+), B-cells (CD19+), NK-cells (CD3-CD16+CD56+ cell), and NKT-cells (CD3+CD56+ cells) within CD45+ cells (lymphocytes) in 80 patients with stage IIIB-IIIC NSCLC, and in 40 healthy controls using eight-color flow cytometry. Results: In patients with stages IIIB-IIIC primary NSCLC, changes within immunocompetent blood cells were found. Moreover, it was unveiled that quantitative changes affected all major immunocompetent cells. A decrease in the proportion of CD4+ T cells and B lymphocytes and an increase in the number of NK and NKT cells were found. Also, an increase in the number of double-positive CD4+CD8+ T cells was revealed, as well as a significant increase in the proportion of B1a (CD5+CD19+) cells among B lymphocytes (qualitative disorders). Conclusion: The revealed multidirectional changes among immunocompetent peripheral blood cells in patients with locally advanced NSCLC (stages IIIB-IIIC) can be beyond doubt considered as signs of systemic immune disorders in this cohort (secondary immunodeficiency).
背景：不可切除的非小细胞肺癌（NSCLC）主要治疗方式为放化疗，但其毒性相对较高。免疫纠正疗法可能是降低该疗法毒性的可行选择。此类治疗的适用性需基于患者免疫系统反应进行合理评估，这证实了在初诊NSCLC患者中验证系统性免疫紊乱的重要性。目的：评估IIIB、IIIC期初诊NSCLC患者外周血免疫细胞群特征，并识别该队列中继发性免疫缺陷的迹象。方法：采用八色流式细胞术，对80例IIIB-IIIC期NSCLC患者及40例健康对照者CD45+细胞（淋巴细胞）中循环T细胞（CD3+、CD4+、CD8+）、B细胞（CD19+）、NK细胞（CD3-CD16+CD56+）及NKT细胞（CD3+CD56+）的频率进行分析。结果：IIIB-IIIC期初诊NSCLC患者存在免疫活性血细胞组成变化，且数量变化涉及所有主要免疫活性细胞。研究发现CD4+ T细胞与B淋巴细胞比例下降，NK及NKT细胞数量增加。同时发现双阳性CD4+CD8+ T细胞数量上升，且B淋巴细胞中B1a（CD5+CD19+）细胞比例显著增加（质量性异常）。结论：局部晚期NSCLC（IIIB-IIIC期）患者外周血免疫活性细胞呈现的多向性变化，可明确视为该队列存在系统性免疫紊乱（继发性免疫缺陷）的特征。
肿瘤(癌症)患者之家