Study of the dynamics of parameters of immune status in patients with breast cancer against the background of neoadjuvant chemotherapy

Abstract

Background. In the structure of modern oncological diseases, one of the actual problems of oncology is breast cancer (BC), which ranks second among oncological pathologies in the world. Despite the preventive measures and successes achieved in the therapy of ВС, the incidence rate is constantly increasing. Analysis of data from the World Health Organization proved that ВС is the most common cancer in the world. The number of healthy life years (DALYs) lost to women with this diagnosis is greater than that of any other type of cancer in women worldwide. ВС occurs in all countries of the world in women of any age after reaching puberty, but the incidence rate increases in older age. Today, modern treatment of ВС remains a staged, multi-component process that requires an individual approach. Neoadjuvant polychemotherapy (NAPСT) is the main standard for locally advanced ВС. Carrying out neoadjuvant systemic therapy allows in vivo determination of tumor sensitivity to chemotherapeutic agents, identification of prognostic «markers», «reduction» of the stage of the oncological process and organ-sparing surgical intervention in this category of patients. However, the use of polychemotherapy (PCT) in ВС can lead to the appearance of side effects, the presence of which depends on the type of drug, the dose of the active substance, the duration of treatment and the characteristics of the patient’s immune status. Purpose – of the work is to study and analyze the data of immune parameters in patients with BC during a course of NAPCT, who were being treated at the Communal non-profit enterprise of the Kharkiv Regional Council «Regional Center of Oncology». Materials and Methods. An immunological study was conducted in 42 breast cancer patients aged 32–58 years. The average age of the patients was 44.8 ± 12.4 years. The control group consisted of 20 healthy individuals without signs of obvious acute and chronic somatic pathology. An immunological study was conducted in 42 breast cancer patients aged 32–58 years. The average age of the patients was 44.8 ± 12.4 years. The control group consisted of 20 healthy people without signs of obvious acute and chronic somatic pathology. The state of the systemic immune response was assessed by the population and subcellular state of peripheral blood lymphocytes. The study was conducted in the dynamics of treatment before the beginning of the 1st course (I period), after the last course (II period) of NAPHT. The material for the study was the serum of patients with BC, which was studied in the dynamics of treatment. Blood for research was taken on an empty stomach from the elbow vein in the amount of 10 ml in a sterile Eppendorf tube. Determination of the phenotype of blood lymphocytes was carried out with the help of laser flow cytometry using the FACS-Calibur machine (USA) and monoclonal antibodies (MAT). For identification on CD3+, CD4+, CD8+, CD16+, CD20+, CD25+, CD8+CD28+, CD8+CD28– cells, appropriate FITC-labeled antibodies were used. To identify INFγ (Th1 cells), IL-4 (Th2 cells), TFRβ1 (Th3 cells) in the cytoplasm of T-lymphocytes, monoclonal antibodies INFγ – PS-5, IL-4 – PE, TFRβ – FITC (eVioscience, Beckman Coulter, R&D System). All stages of sample preparation for laser cytofluorimetry were performed in accordance with the manufacturer’s protocols. Statistical data processing was carried out using the software package «Statistica 10.0 for Windows». For each variation series, the arithmetic mean (M), the mean square deviation (σ), and the mean error of the arithmetic mean (m) were calculated. Student’s t-test was used to detect probable differences. Differences were considered probable at the level of values р < 0,05. The methods of parametric and non-parametric statistics were also used. Results. The study of the dynamics of the main indicators of the cellular and humoral links of immunity in patients on the background of neoadjuvant chemotherapy made it possible to establish a sharp suppression of the relative content of the main subpopulations of lymphocytes with the phenotype of CD3+, CD4+, CD8+, CD16+, CD20+ and CD8+CD28– cells, which certainly indicates about the pronounced immunosuppressive effect of chemotherapy. The level of the CIC in conditional units in patients after a course of NAPHT had a tendency to increase compared to the indicators of control values and before the start of the course of treatment, which is due to the reaction of immunocompetent cells to the elimination of tumor decomposition products against the background of NAPHT. Conclusions. The study of the state of the cellular and humoral link of immunity revealed probable changes in patients with RHZ against the background of NAPHT. Dynamic monitoring of immune status indicators and their correction can be used to prevent complications during NAPHT.