Pre-and Post-chemotherapy Expressions Of T Lymphocyte Subsets In Peripheral Blood And Their Clinical Significance And Activation Analysis With Advanced Head And Neck Cancer Patients

Objective:T-lymphocyte and T-lymphocyte subsets cell are the major forms of cellular immunity. Study of these cells may lead to the better understanding of the function of cellular immunity in the onset and development of carcinoma. CD4+/CD8+ ratio reflect a certain degree of body status of immunologic balance; TCR and CD28 are Signal Pathway for T lymphocytes activation, and study the expression of TCR and CD28 to recognize the status of T lymphocytes activation. This study aims to investigate the pre-and post-chemotherapy expression levels of CD4+ and CD8+ type cytokines,TCR and CD28 in peripheral blood T lymphocytes, the changes of CD4+/CD8+ ratio and their clinical significance in patients with advanced head and neck cancer.Methods:We choose the cases treated in our hospital from 2009-1 to 2009-12, who had been finally diagnosed as head and neck cancer by pathology.42 patients with advanced head and neck cancer include in the study. The patients were given DDP at a dose of 100mg/m2 intravenously on D1 and 5-Fu at a dose of 800- 1000mg/m2 for 8 hours on D1-D5, every 21 days as a cycle. Each patients was treated at least two cycles. The flow cytomctry was used to investigate the pre-and post-chemotherapy expression levels of CD4+ and CD8+ type cytokines,TCR and CD28 in peripheral blood T lymphocytes, the changes of CD4+/CD8+ ratio and their clinical significance in patients with advanced head and neck cancer.Results:The level of CD3+,CD4+,CD4+/CD8+,TCR and CD28 from peripheral blood after chemotherapy in the whole group of advanced head and neck cancer patients was significantly lower than that in control group, (P<0.05), but the level of CD8+ lymphocyte was higher in carcinoma group. After chemotherapy two cycle, the level of CD3+,CD4+,CD8+,CD4+/CD8+,TCR and CD28 versus before chemotherapy, without significant difference (P>0.05). Interestingly, the levels of TCR and CD28 of peripheral blood in 15 cancer patients who achieved partial response (PR) after chemotherapy were 39.78±6.17 and 46.69±6.12, both were higher than that 30.12±8.17 and 37.39±7.12 before chemotherapy (both P<0.05). Furthermore, the ratio of CD4+/CD8+ after chemotherapy was 1.7±0.78,significantly higher than 0.93±0.55 before chemotherapy(P<0.01), but the level of CD8+ lymphocyte was 34.23±2.43 versus 23.49±6.91, lower than before chemotherapy (P<0.05).Conclusion:Effective chemotherapy may reduce the tumor burden and relieve the shift of CD4+/CD8+ ratio, enhance the levels of TCR and CD28. But to head and neck cancer patients chemotherapy is limited.So improving immune function may be a very important therapeutic measure due to poor response of chemo-therapy in advanced head and neck cancer patients.