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CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
头颈部肿瘤患者放化疗期间外周细胞与体液免疫生物标志物变化的预后意义
英文原题：Prognostic significance of alterations in peripheral cellular and humoral immune biomarkers during radiochemotherapy in head and neck cancer patients.
查看英文原题
Prognostic significance of alterations in peripheral cellular and humoral immune biomarkers during radiochemotherapy in head and neck cancer patients.
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研究概要
放化疗导致外周免疫生物标志物发生显著改变，这些改变进而影响了 HNC 患者的生存。
中文摘要
背景
放化疗对外周血细胞及淋巴细胞计数、免疫球蛋白（Ig）和补体水平的影响尚不清楚。本研究旨在调查放疗（RT）、诱导化疗（ICT）和同步化疗（CCT）对头颈癌（HNC）患者上述指标的影响。
方法
纳入接受常规调强放疗（IMRT）的非转移性 HNC 患者。收集 IMRT 前、期间及之后的外周血细胞、淋巴细胞亚群、补体和免疫球蛋白数据，并对患者定期随访。使用 SPSS（IBM，26.0 版）、R（MathSoft，4.0.3 版）和 GraphPad Prism 进行统计分析和绘图。
结果
共纳入 126 例接受放疗的 HNC 患者，其中 44 例接受 ICT，56 例接受 CCT，123 例有完整生存信息。RT 期间，白细胞、血小板、嗜碱性粒细胞、总淋巴细胞、CD4⁺ 和 CD8⁺ T 细胞、NK 细胞及 B 细胞计数均显著下降。相应地，辅助性 T 细胞与抑制性 T 细胞比值（Th/Ts）以及 B 细胞和 CD4⁺ T 细胞比例也下降。RT 期间中性粒细胞和补体 4（C4）水平升高，NK 细胞比例也升高。ICT 导致血小板、B 细胞和免疫球蛋白 A（IgA）显著减少。CCT 导致白细胞、红细胞、血小板、血红蛋白、粒细胞、总淋巴细胞、B 细胞、CD4⁺ 和 CD8⁺ T 细胞、NK 细胞及免疫球蛋白 G（IgG）减少。广义线性模型（GLM）分析进一步证实，RT 是总淋巴细胞、B 细胞、CD4⁺ 和 CD8⁺ T 细胞、NK 细胞、Th/Ts 比值及 B 细胞和 CD4⁺ T 细胞比例降低的危险因素。ICT 会降低 Th/Ts 比值及免疫球蛋白 M（IgM）和 IgA 水平。CCT 则与总淋巴细胞、B 细胞、CD4⁺ 和 CD8⁺ T 细胞、NK 细胞及 IgG 减少相关。相反，接受 RT、ICT 或 CCT 的患者补体 3（C3）或 C4 水平均较高。重要的是，RT 前或 RT 后淋巴细胞计数或比例（如 CD3⁺、CD4⁺ 和 CD8⁺ T 细胞）较高的 HNC 患者预后较好；RT 前 NK 细胞计数和比例较高则与较差预后相关。此外，RT 前后 C3 和 C4 水平较高与较佳预后相关；RT 前 IgA、免疫球蛋白 E（IgE）、IgG 和 IgM 水平较高则与较差预后相关。
结论
放化疗显著改变了外周免疫生物标志物，而这些改变反过来影响 HNC 患者的生存。
展开英文摘要原文
BACKGROUND
The impacts of radiochemotherapy on peripheral blood cell and lymphocyte cell counts, immunoglobulin (Ig) and complement levels remain unclear. This study aims to investigate the above parameters regulated by radiotherapy (RT), induction chemotherapy (ICT) and concurrent chemotherapy (CCT) in head and neck cancer (HNC) patients.
METHODS
Patients with non-metastatic HNC treated by conventional intensity-modulated radiation therapy (IMRT) were enrolled in this study. Data of peripheral blood cells, lymphocyte subpopulations, complements and immunoglobulins were collected before, during and after IMRT. And conducted regular follow-up on patients. SPSS (IBM, version 26.0), R (MathSoft, 4.0.3) and Graphpad Prism were used to perform statistical analysis and plot figures.
RESULTS
A total of 126 HNC patients undergoing RT were enrolled in this study. Among them, 44 patients received ICT, 56 patients received CCT, and 123 patients had complete survival information. Number of white blood cells (WBCs), platelets, basophils, total lymphocytes, CD4 + and CD8 + T cells, natural killer (NK) cells, B cells declined significantly during RT. Accordingly, the ratio of help T cells to suppressor T cells (Th/Ts) and the percentages of B cells, CD4 + T cells also declined. There were increased levels of neutrophils and complement 4 (C4) and percentage of NK cells during RT. ICT caused significant reductions of platelets, B cells and immunoglobulin A (IgA). CCT reduced WBCs, red blood cells (RBCs), platelets, hemoglobin (HGB), granulocytes, total lymphocytes, B cells, CD4 + and CD8 + T cells, NK cells and immunoglobulin G (IgG). Generalized linear model (GLM) analysis further confirmed that RT was a risk factor for lower total lymphocytes, B cells, CD4 + and CD8 + T cells, NK cells, Th/Ts ratios, and lower percentages of B cells, CD4 + T cells. ICT contributed to decreased Th/Ts ratios, and immunoglobulin M (IgM) and IgA levels. As for CCT, it was an unfavorable factor for reduced total lymphocytes, B cells, CD4 + and CD8 + T cells, NK cells and IgG. Conversely, complement 3 (C3) or 4 levels were higher in patients treated with RT, ICT or CCT. Importantly, we found that HNC patients with higher lymphocytes or lymphocyte percentages like CD3 + , CD4 + and CD8 + T cells before or after RT had a better prognosis. While higher NK cells and NK cell percentage before RT were associated with worse prognosis. In addition, higher levels of C3 and C4 before and after RT were associated with a favorable prognosis. However, higher levels of IgA, immunoglobulin E (IgE), IgG, and IgM before RT were associated with poorer prognosis.
CONCLUSIONS
To sum up, chemoradiotherapy resulted in significant alterations in peripheral immune biomarkers which in return influenced HNC patients' survival.
论文信息
- 作者
- Zhu C、Zhang S、Wu Q
- 单位
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, China.China
- 期刊
- Translational cancer research2025 Feb 28
- 原文标识
- PubMed 40104738 · DOI 10.21037/tcr-24-1510
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