Clinical value of peripheral immune function status in the assessment of ‘Deficiency of Vital Qi’ in lung cancer metastasis
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Abstract:
[Abstract] Objective: To investigate the association between peripheral immune function status and lung cancer metastasis, and to identify peripheral blood immune biomarkers for ‘Deficiency of Vital Qi’assessment in lung cancer metastasis. Methods: A retrospective analysis was conducted on peripheral blood immune markers collected before treatment from lung cancer patients admitted into Shanghai Municipal Hospital of Traditional Chinese Medicine, affiliated to Shanghai University of Traditional Chinese Medicine, between March 2023 and April 2025. Patients were categorized into the non-metastatic and the metastatic groups based on the presence of distant metastasis, and the differences in the expressions of immune cells and cytokines between groups were compared. Peripheral blood immune markers with P < 0.05 in univariate analysis were incorporated into a multivariate binary logistic regression model to identify independent predictors of lung cancer metastasis. Results: A total of 193 lung cancer patients were included (101 in the non-metastatic group and 92 in the metastatic group). There were no statistically significant differences between the two groups in terms of gender, age, smoking history, drinking history, or pathological type (all P > 0.05). Univariate analysis revealed significant differences in multiple immune markers between the non-metastatic and metastatic groups (all P < 0.05), including: lymphocyte count, CD3+, CD4+, and CD8+ T, CD19+ B cells, absolute counts of CD3-CD16+CD56+ NK cells, percentages of Treg cells, CD8+CD28+ Treg cells, G-MDSC, and CD3-CD16+CD56+dim NK cells , and levels of cytokine IL-1β, IL-6, and IL-10. Binary logistic regression analysis of differential indicators suggested that the percentage of Treg cells and CD8+CD28+ Treg cells in peripheral blood were independent predictors of distant metastasis in lung cancer (OR = 1.193, 95% CI [1.047, 1.36], P < 0.01; OR = 0.978, 95% CI [0.957, 0.999], P < 0.05). Conclusion: Peripheral blood immune dysfunction is the biological basis for 'qi deficiency' in lung cancer metastasis. This study quantitatively demonstrates the correlation between peripheral immune function status and lung cancer metastasis, providing empirical evidence for the theories of 'qi deficiency and hidden toxicity' and 'metastatic state of tumors'.