Clinical Department of Maxillofacial and Oral Surgery, |University Medical Center, Ljubljana, Slovenia.
Department of Maxillofacial and Oral Surgery, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1104, Ljubljana, Slovenia.
BMC Cancer. 2018 Mar 1;18(1):235. doi: 10.1186/s12885-018-4136-9.
The immune system has a known role in the aetiology, progression and final treatment outcome of oral squamous cell cancers. The aim of this study was to evaluate the influence of radical surgery and radiotherapy on advanced oral squamous cell carcinoma blood counts, lymphocyte subsets and levels of acute inflammatory response markers.
Blood samples were obtained from 56 patients 5 days before and 10 days after surgery, 30 days and 1 year after radiotherapy. The whole blood count, lymphocyte subsets and inflammatory response markers (C-reactive protein, erythrocyte sedimentation rate, leukocyte count, expression of index CD64 and index CD163 on neutrophils and monocytes) were measured, statistically analysed and correlated with clinical treatment outcomes.
The post-operative period was characterised by the onset of anaemia, thrombocytosis, lymphopenia with reduced B lymphocyte, T helper cell and NK cell counts, and a rise in acute phase reactants. Immediately after radiotherapy, the anaemia improved, the lymphopenia worsened, and thrombocyte levels returned to pre-treatment values. There was a drop in counts across the T and B cell lines, including a reduction in B lymphocytes, naïve and memory T cells with reduced CD4+ and CD8+ counts and a decreased CD4/CD8 ratio. One year after radiotherapy all the lymphocyte subsets remained depressed, the only exception being NK cells, whose levels returned to pre-treatment values.
We concluded that surgery resulted in a stronger acute phase response than radiotherapy, while radiotherapy caused a long-lasting reduction in lymphocyte counts. There was no correlation between any of the pre-treatment parameters and the clinical outcome.
免疫系统在口腔鳞状细胞癌的病因、进展和最终治疗结果中具有已知的作用。本研究旨在评估根治性手术和放疗对晚期口腔鳞状细胞癌血液计数、淋巴细胞亚群和急性炎症反应标志物水平的影响。
从 56 例患者中采集了 5 天前、手术后 10 天、放疗后 30 天和 1 年后的血液样本。测量了全血计数、淋巴细胞亚群和炎症反应标志物（C 反应蛋白、红细胞沉降率、白细胞计数、中性粒细胞和单核细胞上表达的指标 CD64 和指标 CD163），并进行了统计学分析和与临床治疗结果的相关性分析。
术后期间的特点是发生贫血、血小板增多、淋巴细胞减少，B 淋巴细胞、辅助性 T 细胞和自然杀伤细胞计数减少，急性反应物质升高。放疗后立即，贫血得到改善，淋巴细胞减少恶化，血小板水平恢复到治疗前水平。T 和 B 细胞系的计数下降，包括 B 淋巴细胞、幼稚和记忆 T 细胞减少，CD4+和 CD8+计数减少，CD4/CD8 比值降低。放疗 1 年后，所有淋巴细胞亚群仍处于抑制状态，唯一例外的是 NK 细胞，其水平恢复到治疗前水平。
我们得出结论，手术引起的急性期反应强于放疗，而放疗引起的淋巴细胞计数长期减少。任何治疗前参数与临床结果之间均无相关性。
