Department of Stomatology, The First Central Hospital, Baoding, Hebei Province, PR China.
Department of Stomatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30534. doi: 10.1097/MD.0000000000030534.
The aim of this study is to investigate changes of peripheral blood lymphocyte subsets before and after treatment with pembrolizumab for advanced oral cancer and its clinical sig-nificance.
32 patients with advanced oral cancer who received pembrolizumab treatment were selected as observation group, 30 healthy people during the same period were selected as control group. Before treatment and in cycles 1, 2, 3 and 4 after treatment, fluid cytometry was used to detect changes in levels of lymphocyte subsets in peripheral blood of patients.
CD3+, CD4+, CD4+/CD8 + indexes of patients with advanced oral cancer before treatment were significantly lower than those in control group (P < .05), CD8 + level was significantly increased (P < .05); After 1 cycle of pembrolizumab treatment, there was no significant difference in changes of lymphocyte subsets compared with before immunotherapy; After 2 and 3 cycles of treatment, CD3+, CD4+, CD4+/CD8 + values were higher than before the treatment (P > .05), CD8 + index was slightly lower than before treatment (P < .05); After fourth cycle of treatment, CD3+, CD4+, CD4+/CD8 + values were significantly improved compared to before treatment (P < .05), CD8 + index was significantly lower than before treatment (P < .05); In treatment process of patients with stable disease (SD)/partial response (PR), the CD3+, CD4+, CD4+/CD8 + values of fourth cycles were higher than before treatment (P < .05), CD8 + index was lower than before treatment (P < .05); During treatment of progressive disease (PD) patients, changes of lymphocyte subsets in fourth cycles were not significantly different from those before treatment (P > .05). This article shows through analysis that expression of programmed cell death ligand 1 (PD-L1) and pathological types have no obvious influence on effect of immunotherapy. Multi-factor analysis shows that it is more meaningful to observe the changes of CD3+, CD4 + and CD8 + at the same time to predict effect of immunotherapy.
Pembrolizumab can regulate changes of T lymphocyte subsets in patients with advanced oral cancer, improve immune status of patients, there is no obvious adverse reaction. Monitoring changes of lymphocyte subsets during treatment can predict effect of immunotherapy.
本研究旨在探讨晚期口腔癌患者使用帕博利珠单抗治疗前后外周血淋巴细胞亚群的变化及其临床意义。
选取 32 例接受帕博利珠单抗治疗的晚期口腔癌患者作为观察组，同期选取 30 名健康人作为对照组。于治疗前及治疗 1 个周期、2 个周期、3 个周期、4 个周期时，采用流式细胞术检测患者外周血淋巴细胞亚群水平的变化。
治疗前晚期口腔癌患者的 CD3+、CD4+、CD4+/CD8+指数均显著低于对照组（P<0.05），CD8+水平显著升高（P<0.05）；使用帕博利珠单抗治疗 1 个周期后，与免疫治疗前相比，淋巴细胞亚群变化无明显差异；治疗 2 个周期、3 个周期后，CD3+、CD4+、CD4+/CD8+值均高于治疗前（P>0.05），CD8+指数略低于治疗前（P<0.05）；治疗 4 个周期后，CD3+、CD4+、CD4+/CD8+值与治疗前相比显著改善（P<0.05），CD8+指数显著低于治疗前（P<0.05）；在疾病稳定（SD）/部分缓解（PR）患者的治疗过程中，第 4 个周期的 CD3+、CD4+、CD4+/CD8+值高于治疗前（P<0.05），CD8+指数低于治疗前（P<0.05）；在进展期疾病（PD）患者的治疗过程中，第 4 个周期的淋巴细胞亚群变化与治疗前无明显差异（P>0.05）。本文通过分析表明，程序性死亡配体 1（PD-L1）的表达和病理类型对免疫治疗效果无明显影响。多因素分析表明，同时观察 CD3+、CD4+和 CD8+的变化对预测免疫治疗效果更有意义。
帕博利珠单抗可调节晚期口腔癌患者 T 淋巴细胞亚群的变化，改善患者免疫状态，无明显不良反应。治疗过程中监测淋巴细胞亚群的变化可预测免疫治疗效果。
