外周血淋巴细胞特征谱可预测接受放射性碘治疗的甲状腺乳头状癌患者的疗效

This study aimed to evaluate the predictive role of peripheral blood lymphocyte subsets in therapeutic efficacy for papillary thyroid cancer (PTC) patients undergoing radioactive iodine (RAI) therapy.

A retrospective analysis was conducted on 405 PTC patients received RAI therapy. Peripheral blood lymphocyte subsets (CD3+, CD4+, CD8+ T cells, B cells, and NK cells) were measured using flow cytometry. Clinical outcomes were categorized as excellent/indeterminate response (ER/IDR) or biochemical/structural incomplete response (BIR/SIR) based on the 2015 ATA guidelines. Statistical analyses included ROC curves, Mann-Whitney U-tests, and multivariate regression.

Lymphocyte profiles varied with clinical features: older age ( 55 years) correlated with reduced CD8+ T cells (P < 0.001), while BRAFV600E-positive patients showed lower CD4+ and CD3+ T cells (P = 0.02). Lymph node metastasis (N1a/b) was associated with suppressed NK cell activity (P = 0.02) but elevated T-cell percentages (P = 0.01). B-cell counts and CD4/CD8 ratios were significant predictors of RAI response. Patients with BIR/SIR exhibited higher B-cell counts (250.0 vs. 219.0 cells/ L, P = 0.001) and CD4/CD8 ratios (1.6 vs.1.4, P = 0.02) compared to patients with ER/IDR. ROC analysis demonstrated moderate predictive accuracy for B cells (AUC = 0.601, P = 0.001) and CD4/CD8 ratios (AUC = 0.567, P = 0.027).

Peripheral blood lymphocyte subsets, particularly B-cell levels and CD4/CD8 ratios, may serve as biomarkers for predicting therapeutic efficacy in PTC. These findings highlight the clinical relevance of integrating immune status assessment into therapeutic decision-making, offering potential for personalized treatment strategies.