Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Ji'nan, Shandong 250012, China.
Medical Management Service Center of Health Commission of Shandong Health commission, Ji'nan, Shandong 250014, China.
Chin Med J (Engl). 2021 Apr 8;134(8):954-962. doi: 10.1097/CM9.0000000000001475.
Recently, T-helper 17 (Th17) cells have been proved to play an important role in promoting cervical cancer. But, till now, few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments. This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer (LACC) patients before and after concurrent chemoradiotherapy (cCRT) and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.
A prospective study with 49 LACC (International federation of gynecology and obstetrics [FIGO] stage IIB-IIIB) patients and 23 controls was conducted. Patients received the same cCRT schedule and were followed up for 3 years. Circulating Th17 cells (CD3+CD8- interleukin [IL]-17+ T cells) and related cytokines IL-17, transforming growth factor-β (TGF-β), IL-10, IL-23, IL-6, and IL-22 were detected before and after cCRT. Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed. Kaplan-Meier analysis was used for overall survival (OS) and progression-free survival (PFS).
We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study. The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls, and it significantly decreased after cCRT (P < 0.05). After cCRT, patients were divided into two groups based on the average of the Th17 cells declined. The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times. Compared with the control patients, LACC patients had higher IL-6, IL-10, IL-22, TGF-β levels and a lower IL-23 level (P < 0.05). After cCRT, IL-6, IL-10, IL-17, IL-23 level significantly increased and TGF-β level significantly decreased compared with the levels before cCRT (P < 0.05).
Circulating Th17 cells in the LACC patients (FIGO stage IIB-IIIB) were higher than those in the controls, but they generally decreased after cCRT. A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.
最近，T 辅助 17（Th17）细胞已被证明在促进宫颈癌中起重要作用。但是，到目前为止，很少有研究探讨这些细胞在肿瘤治疗效果中的作用。本研究旨在探讨局部晚期宫颈癌（LACC）患者在同步放化疗（cCRT）前后循环 Th17 细胞及其相关细胞因子的变化，并分析 Th17 细胞变化与治疗效果之间的相关性。
对 49 例 LACC（国际妇产科联合会[FIGO]分期 IIB-IIIB）患者和 23 例对照者进行前瞻性研究。患者接受相同的 cCRT 方案治疗，并随访 3 年。检测 cCRT 前后循环 Th17 细胞（CD3+CD8-白细胞介素[IL]-17+T 细胞）及其相关细胞因子 IL-17、转化生长因子-β（TGF-β）、IL-10、IL-23、IL-6 和 IL-22。分析循环 Th17 细胞变化与治疗效果的相关性。采用 Kaplan-Meier 分析总生存期（OS）和无进展生存期（PFS）。
我们发现 40 例患者完成了整个 cCRT 方案，达到了本研究的终点。LACC 患者的循环 Th17 细胞百分比高于对照组，cCRT 后显著下降（P<0.05）。cCRT 后，根据 Th17 细胞下降的平均值将患者分为两组。cCRT 后循环 Th17 细胞明显下降的亚组患者治疗效果更好，PFS 和 OS 时间更长。与对照患者相比，LACC 患者的 IL-6、IL-10、IL-22、TGF-β水平较高，IL-23 水平较低（P<0.05）。cCRT 后，与 cCRT 前相比，IL-6、IL-10、IL-17、IL-23 水平显著升高，TGF-β水平显著降低（P<0.05）。
LACC 患者（FIGO 分期 IIB-IIIB）的循环 Th17 细胞高于对照组，但 cCRT 后普遍下降。cCRT 后循环 Th17 细胞下降更明显与更好的治疗效果和更长的 PFS 和 OS 时间相关。
