Effects Of Radiotherapy On Peripheral Blood Lymphocyte Subsets And Levels Of Inflammatory Factors In Patients With Cervical Cancer

Objective:By detecting the levels of peripheral blood lymphocyte subsets and related inflammatory factors in patients with cervical cancer before and after radiotherapy to compare and analyze their dynamic changes,to evaluate the immune status of patients during radiotherapy,and to further clarify the effect of radiotherapy on the levels of peripheral blood lymphocytes and inflammatory factors in patients with cervical cancer,so as to provide scientific theoretical basis for optimizing the treatment of cervical cancer.Methods:A total of 45 patients with cervical cancer diagnosed in the affiliated Hospital of Yan’an University and received radiotherapy in the Oncology Department from December 2020 to January 2022 were selected according to the inclusion and exclusion criteria of the research subjects,aged from 29 to 78 years old,covering clinical stage I-III,all of them were squamous cell carcinoma diagnosed by histopathological biopsy,and the clinical records were complete and available.The number and percentage of T lymphocyte subsets(including CD3~+,CD4~+,CD8~+,CD4~+/CD8~+),B cells(CD19~+),NK(CD16~+CD56~+)cells,inflammatory factors(IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γ),clinical stage,tumor size,pathological type,tumor differentiation,age,treatment and blood routine before and after radiotherapy.Sample collection time and detection methods:fasting venous blood3ml was extracted from patients with cervical cancer before radiotherapy and within 48hours after radiotherapy,and the serum was separated by centrifugation.The levels of peripheral blood lymphocyte subsets and inflammatory factors were determined by Flowcytometry(FCM).The data were collated and analyzed by SPSS25.0 software package.Results:1.The numbers of CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte,B lymphocytes and NK cells in peripheral blood of patients with cervical cancer before radiotherapy were not related to the clinicopathological features:age,tumor size,treatment methods(P>0.05).However,the difference of CD4~+/CD8~+ratio among different age groups was statistically significant(P<0.05).2.Before radiotherapy,the numbers of CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte,B lymphocytes and NK cells in the low-moderately differentiated group were significantly lower than those in the well-differentiated group(P<0.05).3.The peripheral blood lymphocyte subsets of patients with cervical cancer before radiotherapy were closely related to clinical stages:CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte,B lymphocyte and NK cell count in patients with cervical cancer were significantly different between stageⅠtoⅢ(P<0.05).4.The numbers of CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte,B lymphocytes and NK cells in peripheral blood of patients with cervical cancer decreased after radiotherapy,and the difference was statistically significant(P<0.05).5.The numbers of CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte,B lymphocytes and NK cells in peripheral blood of cervical cancer patients with different stages after radiotherapy were significantly lower than those before radiotherapy,and the difference was statistically significant(P<0.05).6.The numbers of CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte,B lymphocytes and NK cells in the peripheral blood of patients with cervical cancer after radiotherapy were significantly lower than those of the corresponding patients before radiotherapy(P<0.05).Except for the increase in the percentage of CD8~+T cells(P<0.05)and the change in the percentage of NK cells was not statistically significant(P>0.05),the remaining percentages were basically consistent with the results obtained from the absolute count.7.After radiotherapy,the number of inflammatory factors such as IL-2,IL-4,IL-6,TNF-αand IFN-γin patients with cervical cancer decreased significantly compared with those of the corresponding patients before initial treatment(P<0.05),the number of IL-10 decreased,but the difference was not statistically significant(P<0.05).8.The number of cervical cancer patients with immunosuppression and immune dysfunction before and after radiotherapy was higher than that before radiotherapy,and the difference was statistically significant(P=0.013).9.The decrease of CD3~+T lymphocyte,CD4~+T lymphocyte,CD8~+T lymphocyte and the number of B lymphocytes in patients with cervical cancer after radiotherapy was related to myelosuppression during radiotherapy(P<0.05).The decrease of inflammatory factors after radiotherapy was not related to myelosuppression,and the difference was not statistically significant(P>0.05).Conclusion:The immune function of patients with cervical cancer will decrease in the course of disease progression,and radiotherapy will aggravate this immunosuppressive state to a certain extent,and this side effect is related to the serious hematological toxicity such as myelosuppression caused by the treatment,which may affect the combination with immunotherapy.Therefore,the immune status can be evaluated more accurately by detecting the hematological toxicity of radiotherapy combined with lymphocyte subsets and related inflammatory factors during radiotherapy,and timely adjuvant therapy can be given.It may play a positive role in the recovery of immune function,which will further enhance the treatment tolerance and improve the curative effect.