为了研究T淋巴细胞,中性粒细胞/淋巴细胞比值(NLR)及其对头颈部癌调强放疗后放射性口腔黏膜炎(RIOM)患者的影响。回顾性分析2016年1月至2019年1月148例头颈部肿瘤患者的临床资料。将患者分为RIOM组(n=42例)和非RIOM组(n=106例)。基于他们是否在调强放射治疗后发展了RIOM。分析2组患者治疗前后的T淋巴细胞和NLR;分析RIOM组患者T淋巴细胞与NLR的相关性。我们使用RTOG分级系统对RIOM进行评估和分级。RIOM等级之间的关系,分析RIOM组的T淋巴细胞和NLR。治疗后,CD3+的比例,CD4+,两组治疗后CD8+T淋巴细胞均有下降,RIOM组明显低于非RIOM组,P<0.05。RIOM组NLR显著高于非RIOM组,P<0.05。两组患者总生存期差异无统计学意义(HR=0.82,95%CI:0.43~1.59)。与RIOM组相比,非RIOM组患者的无进展生存期更长(HR=0.57,95%CI:0.33~0.99).在RIOM小组中,NLR与CD3+呈负相关(r=-0.433,P=.004),CD4+(r=-0.644,P<.001)和CD8+T细胞(r=-0.665,P<.001)。RIOM与NLR呈正相关(R=0.621,P<.001),与CD4+T细胞比率(r=-0.449,P=.003)和CD8+T细胞比率(r=-0.307,P=.048)呈负相关,但RIOM与CD3+T细胞比率无关(r=-0.225,P=.152)。对于头颈癌调强放疗后的RIOM患者,T淋巴细胞呈下降趋势,NLR呈上升趋势。此外,T淋巴细胞和NLR与RIOM密切相关,提示临床医生应意识到T淋巴细胞和NLR对放疗患者的重要性。
To investigate T lymphocyte, neutrophil/lymphocyte ratio (NLR) and their impact on patients with radiation-induced oral mucositis (RIOM) after intensity-modulated radiotherapy for head and neck cancer. The clinical data of 148 patients diagnosed with head and neck cancer from January 2016 to January 2019 were retrospectively analyzed. Patients were divided into RIOM group (n = 42 cases) and non-RIOM group (n = 106 cases), based on whether they developed RIOM after intensity-modulated radiation therapy. The T lymphocyte and NLR of the 2 groups were analyzed before and after treatment; The correlation between T lymphocyte and NLR in RIOM group was analyzed. We used RTOG grading system to evaluate and scale the RIOM. The relationship between the grade of RIOM, T lymphocyte and NLR in RIOM group was analyzed. After treatment, the proportion of CD3 +, CD4 +, and CD8 + T lymphocytes in the 2 groups after treatment were decreased, and the RIOM group was significantly lower than non-RIOM group, P < .05. NLR in RIOM group was significantly higher than that in non-RIOM group, P < .05. The data of overall survival showed no significant differences between 2 groups (HR = 0.82, 95% CI: 0.43-1.59). Compared with RIOM group, patients in non-RIOM group showed a longer progress-free survival (HR = 0.57, 95% CI: 0.33-0.99). In RIOM group, NLR was negatively correlated with CD3 + (r = -0.433, P = .004), CD4 + (r = -0.644, P < .001) and CD8 + T cells (r = -0.665, P < .001). RIOM was positively correlated with NLR (R = 0.621, P < .001), negatively correlated with CD4 + T cell ratio (r = -0.449, P = .003) and CD8 + T cell ratio (r = -0.307, P = .048), but RIOM did not correlate with CD3 + T cell ratio (r = -0.225, P = .152). For patients with RIOM after intensity-modulated radiotherapy for head and neck cancer, T lymphocyte showed a downward trend, and NLR showed an upward trend. In addition, T lymphocyte and NLR are closely related to the RIOM, indicating that clinicians should be aware of the importance of T lymphocyte and NLR on patients received radiotherapy.