Department of Breast Surgery, The Third Hospital of Nanchang, No. 2, Xiangshan South Road, Xi hu District, Nanchang City, 330008, Jiangxi Province, China.
Department of General Surgery, The Third Hospital of Nanchang, Nanchang City, 330008, China.
Sci Rep. 2024 Aug 13;14(1):18738. doi: 10.1038/s41598-024-69546-6.
To evaluate the impact of neoadjuvant chemotherapy on perioperative immune function in breast cancer patients, focusing on CD3, CD4, CD8, and natural killer (NK) cells, as well as the CD4/CD8 ratio. We retrospectively reviewed medical records of breast cancer patients who underwent surgery with or without neoadjuvant chemotherapy at our medical center from January 2020 to December 2022. Patients were matched 1:1 based on propensity scores. Immune cell proportions and the CD4/CD8 ratio were compared on preoperative day one and postoperative days one and seven. Among matched patients, immune cell proportions and the CD4/CD8 ratio did not significantly differ between those who received neoadjuvant chemotherapy and those who did not at any of the three time points. Similar results were observed in chemotherapy-sensitive patients compared to the entire group of patients who did not receive neoadjuvant chemotherapy. However, chemotherapy-insensitive patients had significantly lower proportions of CD4 and NK cells, as well as a lower CD4/CD8 ratio, at all three time points compared to patients who did not receive neoadjuvant chemotherapy. Neoadjuvant chemotherapy may impair immune function in chemotherapy-insensitive patients, but not in those who are sensitive to the treatment.
为了评估新辅助化疗对乳腺癌患者围手术期免疫功能的影响，重点关注 CD3、CD4、CD8 和自然杀伤 (NK) 细胞以及 CD4/CD8 比值。我们回顾性分析了 2020 年 1 月至 2022 年 12 月在我们医疗中心接受手术治疗的乳腺癌患者的病历，这些患者接受了或未接受新辅助化疗。根据倾向评分，患者以 1:1 的比例进行匹配。在术前第 1 天、术后第 1 天和第 7 天比较免疫细胞比例和 CD4/CD8 比值。在匹配的患者中，在三个时间点，接受新辅助化疗的患者与未接受新辅助化疗的患者之间的免疫细胞比例和 CD4/CD8 比值均无显著差异。与未接受新辅助化疗的整个患者组相比，在化疗敏感的患者中也观察到了类似的结果。然而，与未接受新辅助化疗的患者相比，化疗耐药的患者在所有三个时间点的 CD4 和 NK 细胞比例以及 CD4/CD8 比值均显著降低。新辅助化疗可能会损害化疗耐药患者的免疫功能，但对敏感患者没有影响。
