Gender and age features of changes in the immunological parameters in patients with thyroid cancer and persons with toxic goiter after radioiodine therapy

Abstract

Background. The purpose: to carry out a comparative analysis of the cytotoxic activity of natural killer (NK) cells and the metabolic activity of neutrophils before and after radioiodine therapy (RIT) in patients with differentiated thyroid cancer depending on gender, age, the presence of distant metastases and in persons with toxic goiter (toxic goiter) depen­ding on gender. Materials and methods. Immunological parameters were evaluated in three groups of thyroidectomized patients with thyroid cancer. Group 1 included 48 people (30 women, 18 men) of young age (from 11 to 39 years) without distant metastases of thyroid cancer. Group 2 consisted of 40 patients (23 women, 17 men) of young age (from 16 to 40 years) with distant metastases of thyroid cancer. Group 3 consisted of 55 patients (30 women, 25 men) of older age (from 41 to 75 years) with distant metastases of thyroid cancer. The average number of RIT courses in women of group 1 was 1.10 ± 0.04, in men — 1.50 ± 0.24, in women of group 2 — 5.4 ± 0.7, in men — 6.3 ± 0.8. In older patients (group 3), the average number of RIT courses was 5.4 ± 0.3 in women, and 5.5 ± 0.7 in men. Immunological parameters were evaluated in 30 patients (22 women, 8 men) with toxic goiter aged 23 to 67 years. Patients with toxic goiter received a course of RIT. Immunological study was carried out the day before RIT and 5 or 6 days after it. The cytotoxic activity of NK cells against indicator target cells was determined using spectrophotometry. The metabolic acti­vity of neutrophils was studied in a standard test for the reduction of nitroblue tetrazolium. Results. In the early stages after RIT, the activity of NK cells decreased in young men of group 1. In young men of group 2, the activity of NK cells after RIT decreased to a greater extent than in group 1. The activity of NK cells in older men of group 3 both before and after RIT was significantly lower than that of women and significantly lower than that of young men. After RIT, the metabolic activity of neutrophils increased in men and women with thyroid cancer in group 1 and in men of group 2. In women of group 1, this indicator was significantly higher than in men. In men and women of group 2, the metabolic activity of neutrophils after RIT was significantly lower than in patients of group 1. In male patients with toxic goiter, the activity of NK cells the day before RIT was lower, and the metabolic activity of neutrophils was much higher than in women. After RIT, an increase in the activity of NK cells in toxic goiter patients occurs to a greater extent in females, and in the metabolic activity of neutrophils — in males. Conclusions. A comparative analysis of the results of studying the early effect of 131I on the cytotoxic activity of NK cells and the metabolic activity of neutrophils revealed the peculiarities of changes in these parameters in patients with thyroid cancer depending on age, gender, the presence of distant metastases, and in patients with toxic goiter — depending on gender.

Keywords

• thyroid cancer
• distant metastases
• toxic goiter
• radioiodine therapy
• nk cell activity
• metabolic activity of neutrophils
• age
• male gender