| Research Background: Head and neck tumors refer to malignant tumors occurring in nasopharynx,oral cavity,oropharynx,hypopharynx,larynx,nasal sinuses and other parts of the world,and are among the top ten malignant tumors in the world.Radiotherapy,chemotherapy and surgery are the main treatments for head and neck tumors.The level of serum tumor markers is closely related to the occurrence,development,regression and recurrence of malignant tumors,and has high clinical value in the diagnosis and disease monitoring of malignant tumors.The proliferation of head and neck tumor cells is active,cellular immune function is inhibited,and the dynamic balance of CD3+T cells,CD4+T cells and CD8+ T cells is disregulated.The rate of CD4/CD8 is also used as an indicator of cellular immune function.However,there are few studies on the Tumour Abmormal Protein(TAP)as a predictive index before and after treatment of head and neck tumors,and the correlation between TAP and immune function is also worth attention.Experimental purposes: This article aims to explore the application value of tumour abmormal protein(TAP)expression in the diagnosis of head and neck tumors,analyze the changes and correlations of TAP and T lymphocyte subsets before and after chemoradiotherapy,and explore these changes Prognostic significance of and correlations in head and neck tumors.Experimental methods: A total of 67 patients with head and neck tumors who were admitted to the Department of Medical Oncology in our hospital from September 24,2021 to May 4,2022 were selected.The enrolled patients were all pathologically diagnosed malignant tumors with clear staging,and the anti-tumor treatment plan was mainly chemoradiotherapy.The TAP detection indexes in peripheral blood of patients before treatment,after treatment and 3 months after treatment were collected,the release of TAP was detected by TAP detection kit and TAP image analyzer,and the expression level of TAP in staged treatment,after treatment and 3 months after treatment.For quantitative data,the statistical description method of mean ± standard deviation was used;for categorical data,the statistical description method of the number of cases(%)was used Kruskal-Wallis test for statistical analysis;The Kruskal-Wallis test was used for statistical analysis on the difference of TAP value at the same time of different chemoradiotherapy effects.T lymphocyte subsets in venous blood were detected by cellular immunoassay system.The values of CD3+ T cells,CD4+ T cells,CD8+ T cells,and CD4/CD8 were collected before treatment,after treatment,and 3 months after treatment.To analyze the relationship between T lymphocyte subsets and TAP expression,Spearman’s rank correlation coefficient was calculated for the correlation between CD3+T cells,CD4+T cells,CD8+T cells,CD4/CD8 ratio and TAP expression and hypothesis testing was performed;Wilcoxon signed rank test or Friedman test was used for statistical analysis on the changes of CD3+T cells,CD4+T cells,CD8+T cells,CD4/CD8 ratio and TAP values before and after radiotherapy and chemotherapy.Experimental results: 1 The positive rate of TAP before chemoradiotherapy was 73.1%,and the positive rate after chemoradiotherapy was 85.1%.The objective response rate(ORR)was 71.6%,and the disease control rate(DCR)was 94.2%.2 The expression level of TAP before treatment in patients with head and neck cancer was not related to age,gender,disease diagnosis,pathological type,clinical stage,distant metastasis and lymph node metastasis.3 TAP values before and after chemoradiotherapy were statistically significant,and the expression level of TAP was related to the efficacy of chemoradiotherapy.In the stable disease group,the average TAP value before chemoradiotherapy was 186.24 ± 80.54 um2,and the average TAP value after chemoradiotherapy was 198.21 ± 90.68 um2,the difference between before and after was 11.97 ± 117.52 um2,P = 0.650 > 0.05,the difference between before and after TAP was the smallest.In the remission group,the average TAP value before chemoradiotherapy was 161.34 ± 63.09 um2,and the average TAP value after chemoradiotherapy was234.26 ± 111.97 um2,compared with before chemoradiotherapy,P < 0.001,which was statistically significant,and the difference was 72.93 ± 107.82um2(P < 0.001).In the disease progression group,the difference between before and after was 96.32 ± 56.42,P = 0.068 > 0.05,there was no statistical difference,the difference between the two groups was slightly larger,but the difference between the groups was not statistically.There were statistically significant differences in TAP values in the remission group before and after radiotherapy and after radiotherapy and chemotherapy for more than 3 months.In the remission group,the average TAP value before chemoradiotherapy was 168.77 ± 54.69 um2,the average TAP value after chemoradiotherapy was 259.74 ± 118.21 um2,and the average TAP value in the re-examination within 3 months of chemoradiotherapy was 158.17 ± 64.46 um2,The above differences in TAP expression values were statistically significant.The average TAP value of the stable disease group before chemoradiotherapy was 157.23 ± 60.62 um2,the average TAP value after chemoradiotherapy was 204.99 ± 106.86 um2,and the average TAP value after chemoradiotherapy was reviewed within 3 months.The value was 163.94 ± 54.88 um2,and there was no significant difference in TAP expression.It can be seen that there was no significant difference in the expression of TAP in the stable disease group before and after radiotherapy,and more than 3 months after chemoradiotherapy.There was no significant difference in the expression of TAP between different treatment groups at the same time.The difference of TAP before and after chemoradiotherapy was greater in stage Ⅰ-Ⅱ group(difference before and after 85.69±123.67,P=0.013)than in stage Ⅲ-Ⅳ(difference before and after 52.17±104.8,P = 0.001),but this between-group difference was not statistically significant.The difference of TAP before chemoradiotherapy and more than 3 months after chemoradiotherapy was greater in stage Ⅰ-Ⅱ group than in stage Ⅲ-Ⅳ group,but the difference between groups was not statistically significant.4 Before chemoradiotherapy,the coefficient between TAP and the number of CD3+ T cells was 0.396,the Spearman rank correlation coefficient between TAP and the number of CD4+ T cells was 0.385,and the coefficient between TAP and the number of CD8+ T cells was 0.311.It can be seen that TAP is positively correlated with the expression of CD3+,CD4+,CD8+ T cells and the correlation is statistically significant,and it is positively correlated with CD4/CD8 and the correlation is not statistically significant.After chemoradiotherapy,the coefficient between TAP and the number of CD3+ T cells was 0.440,the Spearman rank correlation coefficient between TAP and the number of CD4+ T cells was 0.365,and the coefficient between TAP and the number of CD8+ T cells was 0.422,It can be seen that TAP is positively correlated with the number of CD3+,CD4+,and CD8+ T cells,the P value is statistically significant,and it is negatively correlated with CD4/CD8,but the two have no statistical significance.More than 3 months after chemoradiotherapy,the Spearman rank correlation coefficient between TAP and the number of CD4+ T cells was 0.408,while the coefficient between TAP and the number of CD3+ T cells was 0.346,and the coefficient between TAP and the number of CD8+ T cells was 0.346 was 0.156,and the coefficient between TAP and CD4CD8 was 0.308.There was a positive correlation between TAP and the number of CD4+ T cells and the correlation was statistically significant,but there was no statistical significance with the number of CD3+,CD4+,and CD8+ T cells.Experimental conclusions: 1 The positive rate of TAP in peripheral blood is higher in patients with head and neck tumors,reaching 73.1%,which can be used for early diagnosis or auxiliary diagnosis of head and neck tumors.2 The expression level of TAP in head and neck tumor before chemoradiotherapy was not related to its clinicopathological characteristics.3 The expression level of TAP in patients with head and neck tumors is related to the efficacy of chemoradiotherapy.Monitoring TAP expression in peripheral blood can reflect the therapeutic effect to a certain extent,and can be used for dynamic monitoring during treatment.4 There is a certain correlation between TAP and T lymphocyte subsets in peripheral blood of head and neck tumor patients. |
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