Российский биотерапевтический журнал. 2020; 19: 81-88
ВОЗРАСТНЫЕ ОСОБЕННОСТИ СИСТЕМНОГО ПРОТИВООПУХОЛЕВОГО ИММУННОГО ОТВЕТА У БОЛЬНЫХ ПЕРВИЧНО-ОПЕРАБЕЛЬНЫМ РАКОМ МОЛОЧНОЙ ЖЕЛЕЗЫ И РАКОМ СЛИЗИСТОЙ ОБОЛОЧКИ ПОЛОСТИ РТА
https://doi.org/10.17650/1726-9784-2019-19-1-81-88Аннотация
Введение. Возраст – это важный клинико-патологический фактор у онкологических пациентов. Злокачественные опухоли чаще развиваются у лиц старшего возраста, но заболевание у них протекает менее агрессивно, чем у молодых пациентов. По мнению различных авторов, влияние возраста на развитие опухолей в значительной степени обусловлено возрастными особенностями иммунной системы.
Цель исследования – определение взаимосвязи показателей системного противоопухолевого иммунного ответа и возраста больных первично-операбельным раком молочной железы (ПО РМЖ) и раком слизистой оболочки полости рта (РСОПР).
Материалы и методы. В исследование были включены больные со всеми подтипами ПО РМЖ (n = 145) и больные РСОПР (n = 29). Проводилось иммунофенотипирование лимфоцитов периферической крови с использованием широкой панели моноклональных антител к маркерам клеток адаптивного и врожденного иммунитета.
Результаты. У больных ПО РМЖ 40 лет и старше до лечения процент активированных СD25+-лимфоцитов, СD4+CD25+- и CD3+CD4+-Т-клеток, NKT-клеток, активированных HLA-DR+-лимфоцитов, включая активированные CD3+HLA-DR+-Тклетки, был статистически значимо выше, чем у больных моложе 40 лет. У пациенток этой группы наблюдалось повышение по сравнению с контрольной группой процента цитотоксических Т-лимфоцитов CD8+CD11b+CD28 – , снижение числа «наивных» лимфоцитов (CD4 – CD62L+ и CD8+CD11b – CD28+), а также тенденция к снижению CD4+CD25+CD127 – -Трег на фоне увеличения числа CD4+CD25+-Т-клеток. У больных РСОПР выявлены увеличение с возрастом количества клеток некоторых популяций эффекторного звена иммунитета и снижение числа лимфоцитов-супрессоров.
Заключение. Полученные результаты позволяют предположить, что возрастные различия в состоянии системного противоопухолевого иммунного ответа вносят свой вклад в более благоприятное течение РМЖ и некоторых других злокачественных новообразований у лиц старшего возраста. Очевидно, что особенности возрастных различий в иммунном ответе на опухоль необходимо учитывать при назначении системной терапии, включая иммунотерапию.
Все пациенты подписали информированное согласие на участие в исследовании.
Список литературы
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Russian Journal of Biotherapy. 2020; 19: 81-88
AGE-RELATED FEATURES OF SYSTEMIC ANTITUMOR IMMUNE RESPONSE IN PATIENTS WITH PRIMARY OPERABLE BREAST CANCER AND CANCER OF THE ORAL MUCOSA
https://doi.org/10.17650/1726-9784-2019-19-1-81-88Abstract
Introduction. Age is considered as an important clinical and pathological factor in cancer patients. Malignant tumors are more likely to develop in older people, but the disease is less aggressive than in young patients. According to various authors, the influence of age on the development of tumors largely depends on the age-related features of the immune system.
The aim of the present study was to determine the relationship of indicators of systemic antitumor immune response with the age of patients with primary operable breast cancer and cancer of the oral mucosa.
Materials and methods. The study included patients with all subtypes of primary-operable breast cancer (n = 145) and patients with cancer of the oral mucosa (n = 29). Immunophenotyping of peripheral blood lymphocytes was performed using a wide panel of monoclonal antibodies to markers of adaptive and innate immunity cells.
Results. In elder patients (40 years and older) with primary-operable breast cancer, the percentage of activated CD25+ lymphocytes and CD4+CD25+ and CD3+CD4+ T cells, NKT cells, activated HLA-DR+ lymphocytes, including activated CD3+HLA-DR+ T cells before treatment, was statistically significantly higher than in patients younger than 40 years. Patients of this group showed increase of CD8+CD - 11b+CD28– CTLs and a decrease in the number of naive lymphocytes (CD4 – CD62L+ and CD8+CD11b – CD28+) in comparison with control percentage, and the downward trend in CD4+CD25+CD127– Treg, with increased numbers of CD4+CD25+ T cells. In patients with cancer of the oral mucosa, an increase in the number of cells of some populations of the immune effector link and a decrease in the number of suppressor lymphocytes were revealed with age.
Conclusion. The results suggest that age-related differences in the state of systemic antitumor immune response contribute to a more favorable course of breast cancer and some other malignancies in older persons. It is obvious that the features of age differences in the immune response to the tumor should be taken into account when prescribing systemic therapy, including immunotherapy.
All patients gave written informed consent to participate in the study
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