Real World Exploration Of Dynamic Changes Of Peripheral Blood Lymphocyte Subsets In Patients With Nasopharyngeal Carcinoma During Radiotherapy And Chemotherapy

Purpose:Nasopharyngeal carcinoma is a malignant tumor with a high prevalence in the southern region of China,and radiotherapy and chemotherapy are the main treatment methods for nasopharyngeal carcinoma.This study explores the distribution and dynamic changes of peripheral blood lymphocyte subsets in different populations at different stages of nasopharyngeal carcinoma treatment,explores the effect of radiotherapy on the immune function of the body,and provides a reference for the"liquid biopsy" of tumor immunity.Methods:This study used the database of nasopharyngeal cancer in Southern Hospital to obtain real-world data.A retrospective cohort of 567 primary patients,438 post-induction chemotherapy patients,210 randomized controlled clinical study patients,212 paclitaxel-based induction chemotherapy patients,427 post-radiotherapy patients,and 19 treatment failure patients was established respectively.Data on the detection of peripheral blood lymphocyte subpopulations before and after primary treatment,after induction chemotherapy,and before and after radiotherapy were analyzed.To explore the peripheral blood immune status of different populations of patients with nasopharyngeal carcinoma at different time points and the relationship with prognosis.Results:The percentages of peripheral blood lymphocyte subsets in patients with primary nasopharyngeal carcinoma were generally consistent with the gender and age stratification characteristics of healthy individuals,with men exhibiting higher regulatory T cell/T4 cell ratios,while the percentages of total T cells,CD8+T cell subsets,naive T cells,and CD28+T cells decreased with increasing age,and CD4+T cells,memory T cells,and CD28-T cells percentages increased.The EBV-positive cohort showed a decrease in CD4+T cells,T4/T8 ratio,and memory T cells and an increase in the percentage of CD28-T cells and regulatory T cells with disease progression.After induction chemotherapy,there was a significant decrease in the percentage of B cells,a significant increase in the percentage of CD8+T cells,and a decrease in the percentage of Treg cells.There were no significant differences in the alterations in the composition of peripheral blood lymphocyte subsets after induction chemotherapy with different agents of platinum and paclitaxel-based drugs.After radiotherapy,the percentage of B lymphocytes,CD4+T cells,and naive and regulatory T cells decreased,and the percentage of CD8+T cells,IL-2 membrane receptors,and memory T cells increased significantly.The percentage of peripheral blood B cells was higher before radiotherapy in patients who failed treatment for locally advanced nasopharyngeal carcinoma,whereas no significant differences were observed in the percentage and rate of change of peripheral blood lymphocyte subsets after radiotherapy versus progression-free survivors.Conclusions:The percentages of peripheral blood lymphocyte subsets in patients with primary nasopharyngeal carcinoma were generally consistent with the gender and age stratification characteristics of healthy individuals,with men exhibiting higher regulatory T cell/T4 cell ratios,while the percentages of total T cells,CD8+T cell subsets,naive T cells,and CD28+T cells decreased with increasing age,and CD4+T cells,memory T cells,and CD28-T cells percentages increased.The EBV-positive cohort showed a decrease in CD4+T cells,T4/T8 ratio,and memory T cells and an increase in the percentage of CD28-T cells and regulatory T cells with disease progression.After induction chemotherapy,there was a significant decrease in the percentage of B cells,a significant increase in the percentage of CD8+T cells,and a decrease in the percentage of Treg cells.There were no significant differences in the alterations in the composition of peripheral blood lymphocyte subsets after induction chemotherapy with different agents of platinum and paclitaxel-based drugs.After radiotherapy,the percentage of B lymphocytes,CD4+T cells,and naive and regulatory T cells decreased,and the percentage of CD8+T cells,IL-2 membrane receptors,and memory T cells increased significantly.The percentage of peripheral blood B cells was higher before radiotherapy in patients who failed treatment for locally advanced nasopharyngeal carcinoma,whereas no significant differences were observed in the percentage and rate of change of peripheral blood lymphocyte subsets after radiotherapy versus progression-free survivors.