Correlation Between Peripheral Blood T-lymphocyte Subsets And Recurrence Of Cervical Cancer After Surgery

Objective:To investigate the correlation between preoperative peripheral blood T lymphocyte subsets and recurrence of cervical cancer after surgery,and to analyze the predictive value of T lymphocyte subsets for cervical cancer recurrence after surgery.Methods:Retrospective case analysis of 439 patients who underwent radical surgery at the Shanxi Oncology Hospital between January 2014 and December 2017.They were divided into relapse groups(n = 53 cases)and non-relapse groups(n = 386 cases)according to postoperative follow-up,with relapse groups as case groups and nonrelapse groups as control groups.To observe the proportion of helper T cells,cytotoxic T cells,and regulatory T cells in the subset of peripheral blood T lymphocytes in the relapse groups and non-relapse groups of whole population and patients with stage IA1-IIA2.Differences in T lymphocyte subsets between relapsed and non-relapsed groups were analyzed using two independent sample t-assays,and general data were compared between relapsed and non-relapsed groups using Chi-square assays.The relationship between T lymphocyte subsets,clinicopathologic factors and recurrence of cervical cancer after surgery was analyzed by logistic regression.Mapping of subjects’ job characteristic curves(ROCs)to analyze the value of T lymphocyte subsets in predicting cervical cancer recurrence after surgery.Results:Levels of peripheral blood helper T cells were lower in the relapsed group than in the non-relapsed group(both P < 0.001),and the levels of peripheral blood cytotoxic T cells and regulatory T cells were higher in the relapsed group than in the non-relapsed group(P = 0.004,< 0.001;P < 0.001,P = 0.002)in the overall population and in IA1-IIA2 patients.Differences in differentiation,clinical stage,vascular invasion,and neuroinvolvement between relapsed and non-relapsed patients were statistically significant in the overall population(both P < 0.05).Differences in differentiation and vascular invasion were statistically significant between relapsed and non-relapsed patients in IA1-IIA2(both P < 0.05).Multivariate logistic regression analysis showed that peripheral blood helper T cells in the overall population inhibited recurrence of cervical cancer after surgery(OR = 0.95,95% CI: 0.90-0.99,P = 0.042).Cytotoxic T cells and regulatory T cells were independent risk factors for recurrence after surgery(OR = 1.04,95% CI: 1.00-1.08,P = 0.038;OR =1.23,95% CI: 1.00-1.50,P = 0.049).Differentiation and clinical stage were independent risk factors for recurrence after surgery(OR = 3.46,95% CI: 1.77-6.75,P < 0.001;OR =4.77,95% CI: 2.25-10.09,P < 0.001).Peripheral blood helper T cells from patients with stage IA1-IIA2 inhibited recurrence of after surgery(OR = 0.94,95% CI: 0.88-1.00,P =0.039).Cytotoxic T cells were independent risk factors for recurrence after surgery(OR =1.07,95% CI: 1.01-1.23,P < 0.001).Differentiation is an independent risk factor for cervical cancer recurrence after surgery(OR = 3.95,95% CI: 1.49-10.46,P = 0.006).However,the level of regulatory T cells in preoperative peripheral blood had no statistically significant effect on the recurrence of cervical cancer(P > 0.05).ROC curve analysis showed that the area under curve(AUC)of helper T cells,cytotoxic T cells and regulatory T cells in the population was 0.645,0.635,0.655,respectively.area under curve(AUC)of helper,cytotoxic,and regulatory T cells in IA1-IIA2 patients was: 0.693,0.801,0.655,respectively.Preoperative peripheral blood T lymphocyte subsets are predictive of recurrence in both overall and IA1-IIA2 patients.Conclusion:Subset levels of T lymphocytes in peripheral blood prior to surgery were associated with recurrence after surgery.In summary,helper T cells are a barrier to cervical cancer recurrence after surgery,but cytotoxic T cells and regulatory T cells are independent risk factors for cervical cancer recurrence after surgery.Preoperative peripheral blood T-lymphocyte subset assays may be associated with recurrence of cervical cancer after surgery.