POSTOPERATIVE RELATIONSHIP BETWEEN CELLULAR IMMUNE STATUS AND CLINICOPATHOLOGICAL CHARACTERISTICS IN DIFFERENTIATED THYROID CANCER PRIOR TO 131I THERAPY

Abstract

Objective To investigate the postoperative relationship between cellular immune status and clinicopathological features in patients with differentiated thyroid carcinoma (DTC) before 131I therapy. Methods We retrospectively included 155 patients with DTC who had undergone total thyroidectomy with neck lymph node dissection plus 131I treatment 1-3 months after the operation in our hospital from March 2018 to February 2019. Peripheral blood natural killer (NK) cells and T cell subsets (CD3+ T cells, CD4+ T cells, CD8+ T cells, and CD4/CD8 ratio) were measured 1 d before 131I therapy. Univariable analysis was used to compare the cellular immunity indicators between patients with different clinicopathological features. Results The level of peripheral blood CD4+ T cells in male patients was significantly lower than that in female patients (t=-2.120,P<0.05). The patients aged ≥55 years showed a significantly higher level of NK cells and significantly lower levels of CD3+ T cells and CD8+T compared with those aged <55 years (z=-2.344, -2.681,t=2.266,P<0.05). The levels of CD3+ T cells, CD4+ T cells, and CD4/CD8 were significantly lower in the patients with maximum tumor diameter >2 cm than in those with maximum tumor dia-meter ≤2 cm (z=2.595, -2.652,t=3.861,P<0.05). The level of CD4+ T cells in the M1 group was significantly lower than that in the M0 group (t=4.035,P<0.05). Conclusion The cellular immune status is associated with the clinicopathological features of patients with DTC after surgery and before 131I therapy, with significantly decreased levels of peripheral blood CD4+ T cells for males, maximum tumor diameter >2 cm, and M1 stage. Monitoring lymphocyte subsets can help guide interventions for patients from the immune perspective.

Keywords

• thyroid neoplasms|immunity, cellular|root cause analysis|neoplasm staging|iodine radioisotopes