Stanciu Adina Elena, Hurduc Anca, Stanciu Marcel Marian, Gherghe Mirela, Gheorghe Dan Cristian, Prunoiu Virgiliu Mihail, Zamfir-Chiru-Anton Adina
Department of Carcinogenesis and Molecular Biology, Institute of Oncology Bucharest, 022328 Bucharest, Romania.
Department of Radionuclide Therapy, Institute of Oncology Bucharest, 022328 Bucharest, Romania.
Cancers (Basel). 2023 Jul 26;15(15):3793. doi: 10.3390/cancers15153793.
No clinical studies have investigated the effect of radioiodine (I)-targeted therapy on the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammatory response markers in patients with differentiated thyroid cancer (DTC) associated with type 2 diabetes mellitus (T2DM) and obesity. This study aimed to assess the relationship between blood radioactivity, body mass index (BMI), and peripheral blood cells three days after I intake in 56 female patients without T2DM (DTC/-T2DM) vs. 24 female patients with T2DM (DTC/+T2DM). Blood radioactivity, measured three days after I intake, was significantly lower in the DTC/+T2DM than in the DTC/-T2DM patients (0.7 mCi vs. 1.5 mCi, < 0.001). The relationship between blood radioactivity and BMI (r = 0.83, < 0.001), blood radioactivity and NLR (r = 0.53, = 0.008), and BMI and NLR (r = 0.58, = 0.003) indicates a possible connection between the bloodstream I uptake and T2DM-specific chronic inflammation. In patients without T2DM, I therapy has immunosuppressive effects, leading to increased NLR (19.6%, = 0.009) and PLR (39.1%, = 0.002). On the contrary, in the chronic inflammation context of T2DM, I therapy amplifies immune metabolism, leading to a drop in NLR (10%, = 0.032) and PLR (13.4%, = 0.021). Our results show that, in DTC/+T2DM, the bidirectional crosstalk between neutrophils and obesity may limit I uptake in the bloodstream. Considering the immune response to I therapy, the two groups of patients can be seen as a synchronous portrait of two sides. The explanation could lie in the different radiosensitivity of T and B lymphocytes, with T lymphocytes being predominant in patients with DTC/-T2DM and, most likely, B lymphocytes being predominant in T2DM.
尚无临床研究调查放射性碘（I）靶向治疗对伴有2型糖尿病（T2DM）和肥胖症的分化型甲状腺癌（DTC）患者中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）这两种炎症反应标志物的影响。本研究旨在评估56例无T2DM的女性患者（DTC/-T2DM）与24例有T2DM的女性患者（DTC/+T2DM）在摄入I后三天血液放射性、体重指数（BMI）和外周血细胞之间的关系。摄入I三天后测得的血液放射性，DTC/+T2DM患者显著低于DTC/-T2DM患者（0.7毫居里对1.5毫居里，<0.001）。血液放射性与BMI之间的关系（r = 0.83，<0.001）、血液放射性与NLR之间的关系（r = 0.53，= 0.008）以及BMI与NLR之间的关系（r = 0.58，= 0.003）表明血流中I摄取与T2DM特异性慢性炎症之间可能存在关联。在无T2DM的患者中，I治疗具有免疫抑制作用，导致NLR升高（19.6%，= 0.009）和PLR升高（39.1%，= 0.002）。相反，在T2DM的慢性炎症背景下，I治疗会放大免疫代谢，导致NLR下降（10%，= 0.032）和PLR下降（13.4%，= 0.021）。我们的结果表明，在DTC/+T2DM中，中性粒细胞与肥胖症之间的双向串扰可能会限制血流中I的摄取。考虑到对I治疗的免疫反应，这两组患者可被视为同一事物两个方面的同步写照。其解释可能在于T淋巴细胞和B淋巴细胞的放射敏感性不同，在DTC/-T2DM患者中T淋巴细胞占主导，而在T2DM中很可能是B淋巴细胞占主导。
