Changes in immune markers in tumor-free lymph node and peripheral blood of malignant head and neck cancer patients.

Background: Immunoediting theory, which explains the balance between the host immunity and cancer cells, could suggest a new way to reduce the recurrence of cancer. This study aimed to compare changes in immune cells in tumor-free lymph node and peripheral blood according to their malignancy, disease status, and prognosis.

Methods: From October 2016 to August 2017, 26 malignant and 14 benign cases were enrolled, and the tumor-free lymph node and peripheral blood were harvested during the surgery. The proportions of cluster of differentiation 4 (CD4), CD8, CD19, CD33, CD40, and CD40 ligand (CD40L) expression and cytokine levels in the serum were compared between the malignant and benign patients. Furthermore, among the malignant group, the changes occurring due to the disease progression or recurrence were evaluated.

Results: In the malignant patients, a significantly decreased proportion of cells expressing CD8 and CD40 in the peripheral blood was observed compared to benign patients. In the advanced stage (stage III or IV) and in patients with extracapsular spread, significant decrease in CD33 cells in tumor-free lymph nodes could be observed. On performing a survival analysis based on the recurrence, patients with interferon-γ (IFNγ) level greater than 16 pg/mL exhibited significantly higher recurrence rate, and this higher level of IFNγ was associated with distant metastasis.

Conclusions: Immune markers exhibiting clinical significance differ from each other based on the comparison between benign and malignant groups, between advanced and early cancer, and between recurrence and nonrecurrence. And this result suggests that research in the immune system is likely to have an important effect on future treatment.