Value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting radiation pneumonitis in patients with esophageal cancer and lung cancer

Abstract

Abstract:

ObjectiveTo investigate the value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting the occurrence of radiation pneumonitis (RP) in patients with esophageal cancer and lung cancer.MethodsThe clinicopathological data of 28 patients with esophageal and 16 patients with lung cancer undergoing radiotherapy from April 2018 to March 2020 in Hefei Cancer Hospital, Chinese Academy of Sciences were retrospectively analyzed, and the patients were divided into RP group (n=16) and non-RP group (n=28) according to whether RP occurred during and after treatment. The CD4/CD8 ratio and total B lymphocytes before radiotherapy between the two groups, and the CD4/CD8 ratio and total B lymphocytes before and after radiotherapy in the RP group were compared. Receiver operating characteristic curve was used to analyze the value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting RP.ResultsThe CD4/CD8 ratio before radiotherapy in the RP group was significantly lower than that in the non-RP group (0.993±0.179vs. 1.708±0.170), with a statistically significant difference (t=2.706,P=0.009); the total B lymphocytes in the RP group was significantly lower than that in non-RP group [(4.409±0.823)%vs.(8.153±1.017)%], with a statistically significant difference (t=0.986,P=0.015). The CD4/CD8 ratio in the RP group was lower than that before radiotherapy when RP occurred (0.785±0.167vs. 0.993±0.179), with no statistically significant difference (t=1.376,P=0.189). The total B lymphocytes in the RP group was lower than that before radiotherapy when RP occurred [(3.487±1.018)%vs. (4.409±0.823)%], with no statistically significant difference (t=0.804,P=0.433). The critical values of CD4/CD8 ratio and total B lymphocytes predicted RP were 0.580 and 0.357, respectively. The areas under the curve (AUC) of CD4/CD8 for predicting RP was 0.802 (95%CI: 0.653-0.932), the sensitivity was 89.29%, and the specificity was 68.75%. The AUC of total B lymphocytes for predicting RP was 0.694 (95%CI: 0.483-0.814), the sensitivity was 85.71%, and the specificity was 50.00%. The AUC of the two combined diagnostic method for RP was 0.834 (95%CI: 0.697-0.932), the sensitivity and specificity were 81.25% and 89.29%. AUC of the two combined tests was significantly higher than that of the single test, with statistically significant differences (Z=1.115,P=0.046;Z=1.992,P=0.026).ConclusionThe CD4/CD8 ratio and total B lymphocytes in the RP group are lower than those in the non-RP group. The CD4/CD8 ratio and total B lymphocytes in the serum are of great significance in predicting the occurrence of RP in patients with malignant tumors receiving chest radiotherapy.

Key words:Esophageal neoplasms,Lung neoplasms,CD4/CD8 ratio,B-lymphocytes,Risk assessment,Radiation pneumonitis

Hu Ge, Su Jie, Li Qiangwei, Xu Peng, Xu Xiuli, Qian Xiaotao. Value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting radiation pneumonitis in patients with esophageal cancer and lung cancer[J]. Journal of International Oncology, 2021, 48(9): 523-526.

Figures/Tables2

一般临床特征	RP组 (n=16)	非RP组 (n=28)	χ²值	P值
性别
男	15	21	1.311	0.252
女	1	7
年龄(岁)
≥60	14	24	0.027	0.768
<60	2	4
病种
食管癌	9	19	0.592	0.441
肺癌	7	9
分期
Ⅰ~Ⅱ	5	11	0.284	0.594
Ⅲ~Ⅳ	11	17
放疗剂量(Gy)
<60	4	8	0.065	0.698
≥60	12	20
同步化疗
有	3	4	0.151	0.627
无	13	24
吸烟史
有	10	17	0.013	0.907
无	6	11

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