Effect of Concurrent Chemoradiotherapy on Regulatory T Cells,CD8/Treg Ratio,PD1 and CTLA-4 in Patients with Cervical Cancer

Abstract

To investigate the significance of chemoradiotherapy on regulatory T (Treg) cells, CD8 / Treg ratio, squamous cell carcinoma antigen (SCC), PD1, and CTLA-4 in the peripheral blood of cervical cancer (CC)patients. A retrospective study was performed 56 cervical cancer patients treated with concurrent chemoradiotherapy from September 06, 2019 to April 19, 2021 were selected, in patients who underwent surgery. Flow cytometry was used to determine the levels of regulatory T cells, CD8 / Treg ratio, squamous cell carcinoma antigen, PD1, and CTLA-4 in the peripheral blood of patients before and after concurrent therapy, Differences in relative level values before and after treatment were calculated using statistical protocols such as the paired samples t-test. The proportion of CD4+CD25+CD127low Treg in CD4+T cells was (15.96±4.29) % in cervical cancer patients and (9.76±4.21) % in healthy controls, and the difference between the two groups was statistically significant (P < 0.05). In different age groups, Treg, CD8 levels, CD4/CD8 ratio and CD8/Treg ratio before and after radiotherapy and chemotherapy had no significant relationship with age and pathological types (P > 0.05), but CD8/Treg ratio was higher in patients with adenocarcinoma than in patients with squamous cell carcinoma after radiotherapy and chemotherapy, and the difference was statistically significant (Z = -2.076 P = 0.038). For postoperative patients, CD8 levels were lower before and after chemoradiotherapy than after chemoradiotherapy (T = -2.320 P = 0.020). In terms of PD1, regardless of age, pathological type, the level of PD1 after radiotherapy and chemotherapy was higher than that before chemotherapy, and the difference was statistically significant. The level of adenocarcinoma (53.50±10.16) % was significantly higher than that of squamous carcinoma (43.72±11.89) % (T = -2.609 P = 0.011). The PD1 level of patients with cervical cancer radical resection (41.64±13.29) % was lower than that of patients without cervical cancer radical resection (46.84±10.61) %, the difference was statistically significant (T = 2.187 P = 0.031). The PD1 level of patients without pelvic lymph node metastasis (48.84±10.04) was significantly higher than that of patients with pelvic lymph node metastasis (42.96±10.85), and the difference was statistically significant (T = -2.019 P = 0.049), There were no significant differences in vascular positivity, invasion depth, stump positivity, pelvic lymph node positivity and Treg level, CD8 level, CTLA4 level, SCC, CD4/CD8 ratio, CD8/Treg ratio (ALL P > 0.05). The level of Treg cells in patients with cervical cancer is significantly higher than that in healthy people, and it does not decrease immediately after radiotherapy and chemotherapy. Peripheral blood Treg, PD1, CD8 and CD8/Treg can reflect the immune function of the body, which may provide a certain reference for immunotherapy.