Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
BMC Cancer. 2020 Mar 4;20(1):173. doi: 10.1186/s12885-020-6633-x.
Alterations in peripheral blood lymphocytes in cervical cancer have been reported, although conflicting views exist. The present study investigated the distributions of lymphocyte subsets in tumor tissue and peripheral blood samples from cervical cancer patients and precancerous lesion patients, and evaluated the correlations of lymphocyte subsets with clinicopathological and prognostic variables.
A total of 44 patients with stage IB1-IIA2 cervical cancer and 13 precancerous lesion patients were included. Lymphocytes were collected from the tumor tissue and the peripheral blood, and isolated by Lymphoprep density gradient centrifugation. The percentages of lymphocyte subsets were quantified by flow cytometry analysis, and the differences between lymphocyte subsets in the tumor tissue and peripheral blood were compared by SPSS. In addition, the relationships between lymphocyte subsets and clinicopathological and prognostic variables were analyzed.
Our results revealed that the amount of total T lymphocytes, CD8+ T cells, granulocytes, pDCs, CD16+ monocytes and CD56 NK cells were significantly higher in the tumor tissue than in the peripheral blood in the cervical cancer patients, while those of CD4+ T cells, CD4+/CD8+ cell ratio, rdT cells, BDCA1+ mDCs, total monocytes, CD14+ monocytes, NK cells and CD56 NK cells exhibited the opposite trend (p < 0.05). The levels of total pDCs and BDCA1+ mDCs in the peripheral blood were significantly lower in the cervical cancer patients than in the precancerous lesion patients, while the proportion of CD16+ monocytes was elevated (p < 0.05). In addition, some lymphocyte subsets, especially CD4+ cells and CD8+ cells, and the CD4+/CD8+ cell ratio were closely associated with clinicopathological and prognostic parameters.
These results suggested that distinct alterations in infiltrating lymphocyte subsets occurred in the tumor and were associated with clinicopathological and prognostic parameters. Systemic impairment of the immune system may occur in the antitumor response of cervical cancer patients.
尽管存在争议，但已有研究报道宫颈癌患者外周血淋巴细胞发生改变。本研究旨在探讨宫颈癌及癌前病变患者肿瘤组织和外周血淋巴细胞亚群的分布，并评估淋巴细胞亚群与临床病理和预后变量的相关性。
共纳入 44 例ⅠB1-ⅡA2 期宫颈癌患者和 13 例癌前病变患者。采用淋巴细胞分离液（Lymphoprep）密度梯度离心法从肿瘤组织和外周血中分离淋巴细胞。采用流式细胞术分析淋巴细胞亚群的百分比，并采用 SPSS 比较肿瘤组织和外周血中淋巴细胞亚群的差异。此外，还分析了淋巴细胞亚群与临床病理和预后变量的关系。
研究结果显示，与外周血相比，宫颈癌患者肿瘤组织中总 T 细胞、CD8+T 细胞、粒细胞、浆细胞样树突状细胞（pDC）、CD16+单核细胞和 CD56+NK 细胞的数量明显增加，而 CD4+T 细胞、CD4+/CD8+细胞比值、初始 T 细胞（rdT）细胞、骨髓来源树突状细胞（mDC）、总单核细胞、CD14+单核细胞、NK 细胞和 CD56+NK 细胞则呈现相反的趋势（p<0.05）。与癌前病变患者相比，宫颈癌患者外周血中总 pDC 和 BDCA1+mDC 的水平明显降低，而 CD16+单核细胞的比例升高（p<0.05）。此外，一些淋巴细胞亚群，尤其是 CD4+细胞和 CD8+细胞，以及 CD4+/CD8+细胞比值与临床病理和预后参数密切相关。
这些结果表明，浸润性淋巴细胞亚群在肿瘤中发生了明显改变，并与临床病理和预后参数相关。宫颈癌患者抗肿瘤反应中可能存在全身性免疫系统受损。
