| Purpose:In this study,we used flow cytometry to detect the absolute values of T lymphocytes,CD4~+T cells,Treg cells,NK cells,the ratio of CD4~+T cells to CD8~+T cells and the ratio of platelets to lymphocytes in the peripheral blood of patients with locally advanced rectal adenocarcinoma before radiotherapy,at the end of radiotherapy and one month after radiotherapy.The above indexes was used to study the changes of immune cell index and inflammatory index in the peripheral blood during radiotherapy,analyze the changes of cellular immunity and inflammation in rectal cancer patients during peri-radiotherapy,explore the relationship between changes and prognosis and to provide a theoretical basis for screening the high benefit population receiving radiotherapy combined with immunotherapy.Methods:1. We selected 54 patients with primary rectal adenocarcinoma who received pelvic precise radiotherap in Anhui provincial hospital from January 2018 to October 2019.The nutritional status of patients was assessed according to the nutritional risk screening.2.Fasting peripheral blood of the selected subjects was collected in 4ml before radiotherapy,at the end of radiotherapy and one month after radiotherapy,and conducted nutritional risk screening.3.We measured the absolute value of lymphocytes and platelets in peripheral blood,as well as the percentage of T lymphocytes,CD4~+T cells,Treg cells and NK cells in lymphocytes,and calculated the absolute value of each immune cell as well as the the PLR ratio.4.The changes of immune indexes in patients during periradiotherapy were calculated by repeated measures of anova,the data was expressed as“`x±s”,One-way repeated measure anova and T test for pairwise comparison between time points in the group were used for inter-group comparison,The differences between groups were compared according to treatment and follow-up,Test level?=0.05.Results:1.The peripheral blood immune indexes of a total of 54 patients with rectal adenocarcinoma were detected and statistically analyzed,we found that the absolute values of T lymphocytes,CD4~+T cells,NK cells and Treg cells decreased at the end of radiotherapy compared with that before radiotherapy,and increased one month after the radiotherapy compared with that at the end of radiotherapy,the results showed significant statistical difference(P<0.05).2. The PLR ratio increased at the end of radiotherapy compared with that before radiotherapy,and decreased one month after radiotherapy compared with that at the end of radiotherapy,but the ratio was still higher one month after radiotherapy than that before radiotherapy,which were statistically significant(P<0.05).3. The CD4~+/CD8~+ratio was higher at the end of radiotherapy than that before radiotherapy,and the CD4~+/CD8~+ratio decreased one month after the end of radiotherapy than that at the end of radiotherapy,the results showed significant statistical difference(P<0.05).In addition,patients were grouped according to the CEA and CA199changes during periradiotherapy,and the CD4~+/CD8~+ratio between the groups were different(P<0.05).4. The absolute values of T lymphocytes,CD4~+T cells,NK cells and Treg cells were negatively correlated with the expression level of PLR,which showed statistically significant differences((P<0.05).5.The absolute value of Treg cells in the pre-albumin decreasing group was lower from the beginning to the end of the radiotherapy than that in the non-decreasing group,which showed statistically significant differences(P<0.05).Conclusion:1.The absolute values of T lymphocytes,CD4~+T cells,NK cells and Treg cells in peripheral blood of patients with locally advanced rectal cancer decreased temporarily during radiotherapy,and began to increase after the end of radiotherapy,suggesting that the radiotherapy mobilized the occurrence of cellular immunity of the body.2.The PLR ratio increased significantly after radiotherapy,and decreased to a certain extent one month after the end of radiotherapy compared with that at the end of radiotherapy,indicating that radiotherapy can trigger the inflammatory response of patients in a short period of time.3.After pelvic radiotherapy,the CD4~+/CD8~+ratio of peripheral blood of patients with locally advanced rectal adenocarcinoma increased during radiotherapy,and decreased after the end of radiotherapy,in addition,the CD4~+/CD8~+ratio of the CEA and CA199elevated groups showed no significant increasing trend during radiotherapy,but showed a fast decreasing trend after radiotherapy,indicating that the low CD4~+/CD8~+ratio indicated a poor prognosis.4. The initial value of PLR ratio before radiotherapy was negatively correlated with the absolute value of T lymphocytes,CD4~+T cells,NK cells,and Foxp3~+Treg cells,which showed an antagonistic relationship between PLR ratio and the potential of various immune cells.5. The absolute value of Treg cells in peripheral blood of patients with locally advanced rectal adenocarcinoma with poor nutritional status was lower than that patients with better nutritional status during and after the end of radiotherapy.The results showed that patients with more active immune function had less effect on nutritional status and better prognosis in the course of radiotherapy and anti-tumor therapy. |
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