目的：研究肺癌患者化疗前后免疫细胞数量、亚群比例、细胞表型及功能的改变，并探讨其临床意义。方法： 对23例次肺癌患者化疗前后的白细胞、淋巴细胞和中性粒细胞计数，以流式细胞术对CD3+、CD4+及CD8+T细胞亚群比例以及记忆样表型T细胞进行检测和分析；体外以PHA刺激外周血淋巴细胞，培养48 h后检测对K562靶细胞的杀伤效应。结果： 化疗后外周淋巴细胞数量迅速减少，1周左右达最低水平，此后逐渐恢复至化疗前水平；淋巴细胞恢复过程中， CD3+、CD8+T细胞亚群比例升高，记忆样表型T细胞（CD44high，CD62Llow）比例增加；增生期淋巴细胞在体外以PHA刺激后对K562细胞的杀伤能力没有下降，个别患者的杀伤能力还有所增强。结论： 肺癌患者化疗后不仅没有降低免疫功能，反而可增强其免疫效应，该结果为临床肿瘤患者化疗后开展免疫生物治疗提供了实验依据。

Objective: To investigate the changes of lymphocytes number, proportions of lymphocyte subsets, phenotypes and the cytotoxic function of lymphocytes in lung cancer patients before and after chemotherapy and to assess its clinical relevance. Methods: White blood cells (WBC), lymphocytes and neutrophils were counted before and after chemotherapy in 23 patients with lung cancer. Flow cytometery technique was used to determine and analyze the proportions and phenotypes of CD3+, CD4+ and CD8+ lymphocyte subsets. Memory-like phenotype and cytotoxic function of lymphocytes against K562 cells were detected after peripheral lymphocytes were simulated with PHA for 48 h. Results: Lymphopenia setting (decreased and ensuing recovered cell numbers of WBC, neutrophils and lymphocytes) was observed after chemotherapy. The proportion of CD3+ T cells and the ratio of CD8+/CD4+ were slightly increased and the memory-like phenotype, CD44high and CD62Llow, were exhibited after chemotherapy. The cytotoxicity of lymphocytes against K562 target cells was not decreased, but increased in some patients. Conclusion: Chemotherapy does not hamper, but improve the immune environment in lung cancer patients, which provides a reference for clinical immunotherapy after chemotherapy.

国家自然科学基金面上项目（30571713）；上海医学院基础临床医学交叉基金2006资助