CHANGES AND SIGNIFICANCE OF LYMPHOCYTE SUBSETS IN PATIENTS WITH ADVANCED NSCLC BEFORE AND AFTER ENDOSTAR COMBINED CHEMOTHERAPY

Gang Wang^{1, 2}, Min Zhou², Liyin Zhu², Aina Yu³, Jiajia Zheng², Jianying Zhou^{1, *}

¹The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China - ²Anji people’ Hospital, Huzhou 313300, China - ³Center for Disease Control and Prevention, Anji County, Huzhou 313300, China

Objective: To investigate the changes in lymphocyte subsets in patients with advanced non-small-cell lung cancer (NSCLC) before and after the treatment using endostar combined with chemotherapy. 

Methods: Eighty-six patients with advanced NSCLC who were treated in the oncology department of our hospital from June 2018 to February 2019 were randomly selected and divided into a control group and study group using the random-number expression method, with 43 patients in each group. The control group was treated using chemotherapy (docetaxel + carboplatin). The patients in the study group were treated with endostar on the basis of the control group, and both groups were treated for 6 weeks. The clinical efficacy of the two groups was evaluated. The levels of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2), and matrix metalloproteinase-9 (MMP-9) were measured using ELISA. The lymphocyte subsets (CD₃⁺, CD₄⁺, and CD₄⁺/CD₈⁺) and natural killer cells (NK) were measured by flow cytometry. The adverse reactions of the two groups were compared. 

Results: After treatment, the objective effective rate and disease-control rate of the two groups were 65.12% and 81.39%; 83.72% and 95.35%, respectively, which were significantly higher in the study group than in the control group (P<0.05). After treatment, the levels of VEGF, MMP-2, and MMP-9 in the two groups were significantly lower than those before treatment, and the indexes in the study group were significantly lower (P<0.05). After treatment, the levels of NK, CD₃⁺, CD₄⁺, and CD₄⁺/CD₈⁺ in the two groups were significantly higher than those before treatment, the levels of CD₈⁺ in the study group were significantly higher than those in the control group, and the levels of CD₈⁺ in the study group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions was 25.58% in the study group and 48.84% in the control group. The incidences of adverse reactions in the study group were significantly lower than those in the control group (P<0.05). 

Conclusion: Endostar combined with chemotherapy has a significant clinical effect in the treatment of advanced NSCLC. It can reduce the levels of VEGF, MMP-2, and MMP-9 in patients with advanced NSCLC; inhibit tumour invasion and metastasis; and improve the immune function of the body in a safe and reliable manner.