Tim3 水平对非小细胞肺癌临床进展及预后的影响

Effect of TIM-3 expression on clinical progress and prognosis of non-small cell lung cancer

摘要:

目的 探讨非小细胞肺癌（NSCLC）患者外周血CD4+T 细胞表面T 细胞免疫球蛋白黏蛋白分 子3（Tim3）的表达, 及其与NSCLC 临床进展及预后的关系。方法 前瞻性收集2013 年9 月-2014 年9 月 于广西中医药大学附属瑞康医院肿瘤内科诊断的69 例NSCLC 患者作为NSCLC 组，同期进行健康体检的 65 例健康人员作为对照组。应用流式细胞仪检测CD4+T 细胞表面Tim3 表达水平。以NSCLC 组Tim3 水 平的中位数为截点分为Tim3 高表达组和Tim3 低表达组，进而分析CD4+T 细胞Tim3 水平与患者临床病 理特征及预后的关系。结果 与对照组患者比较，NSCLC 组患者外周血CD4+T 细胞表面Tim3 水平升高 （P <0.05）。Tim3 高表达与TNM 分期及淋巴结转移有相关性（P <0.05）。Tim3 低表达患者较高表达患者具 有更长的总生存期（P <0.05）。CD4+T 细胞表面Tim3 高表达是NSCLC 总生存期的独立预后因素（P <0.05）。 结论 外周血CD4+T 细胞Tim3 高表达与NSCLC 生存期相关，其可能是NSCLC 预后的生物指标。

Abstract:

Objective To determine the correlations of the expression of T cell immunoglobulin domain and mucin domain-3 (TIM-3) on the surface of CD4+ T cells from peripheral blood with clinical stage and prognosis in the patients with non-small cell lung cancer (NSCLC). Methods A total of 69 patients with NSCLC were consecutively enrolled in this prospective study between September 2013 and September 2014 in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, and 65 healthy people who underwent physical examination in the same period were enrolled as healthy controls. The expression of TIM-3 in peripheral blood was detected by flow cytometry. The NSCLC patients were divided into TIM-3 high-expression group and TIM-3 low-expression group by the median value of TIM-3 on peripheral CD4+ T cells. The relationships of TIM-3 expression with clinical features and prognosis were analyzed. Results The expression of TIM-3 on the CD4+ T cells in the NSCLC patients was significantly higher than that in the healthy controls (P < 0.05). High-expression of TIM-3 was significantly associated with lymph node metastasis and tumor stage (P < 0.05). Kaplan-Meier survival analysis showed that the patients with lower TIM-3 expression exhibited longer overall survival as compared to the patients with high TIM-3 expression (P < 0.05). Cox multivariate regression analysis showed that high expression of TIM-3 was an independent predictor for the overall survival in the patients with NSCLC (P < 0.05). Conclusions TIM-3 expression on CD4+ T cells is associated with clinical stage and overall survival in the NSCLC patients, and it may be a potential biomarker for predicting prognosis in the patients with NSCLC.