Changes in PD-1 expression on T lymphocyte subsets and related immune indicators before and after definitive chemoradiotherapy for esophageal squamous cell carcinoma.

OBJECTIVE

This study aimed to observe the dynamic changes in the expression of T lymphocytes, natural killer (NK) cells, and PD-1 in patients with first-diagnosed esophageal squamous cell carcinoma (ESCC) before and after chemoradiotherapy (CRT) and evaluate the impact of PD-1 expression in peripheral blood on the short-term outcome of patients with ESCC.

PATIENTS AND METHODS

Seventy-three patients with ESCC who were treated with definitive CRT were enrolled. Before and after CRT, flow cytometry was used to detect thePD-1 expression in the peripheral blood and related immune indicators. Peripheral blood from 10 healthy individuals was used as control.

RESULTS

The percentages of CD3 ( = 0.018), CD4 ( < 0.001), and CD8 T cells ( < 0.001); NK cells ( = 0.009); and the CD4/CD8 ratio ( < 0.001), as well as PD-1CD3 ( < 0.001), PD-1CD4 ( < 0.001), and PD-1CD8 ( < 0.001) T cells, before CRT significantly differed from those in the post-CRT group. The percentages of PD-1CD8 T cells differed significantly between the radiotherapy alone and CRT groups ( < 0.05). PD-1 expression in CD3, CD4, and CD8 T cells significantly decreased in patients achieving overall response rate (all  < 0.05). Compared with those in the incomplete response group, PD-1CD8 T cells significantly decreased in the CR group ( < 0.05).

CONCLUSION

CRT aggravated immunosuppression and increased PD-1 expression in T lymphocyte subsets in patients with ESCC, possibly related to the radiation field. PD-1 expression in T lymphocyte subsets can predict short-term outcomes in patients and provide a theoretical basis for the sequential application of PD-1 immunosuppressants after radiotherapy and chemotherapy.