Expression levels of lymphocyte subsets,Tregs and MDSCs in peripheral blood of patients with renal carcinoma and their clinical significances
Objective To measure the expression levels of myeloid-derived suppressor cells(MDSCs),regulatory T-cells(Tregs),CD3+CD4+T cells,CD3+CD8+T cells and CD3+CD16+CD56+T cells in renal carcinoma patients by flow cytometry,and to identify their corr-elation with the progression of renal carcinoma and their clinical significance.Methods From September 2021 to November 2022,44 renal carcinoma patients hospitalized in our hospital were selected,and 29 healthy people were selected as the control group.Early in the morning,3ml of fasting venous blood was collected.Renal carcinoma was pathologically confirmed.Whole blood 9-color,11 parameter flow cytometry was used to detect expression levels of MDSCs,Tregs,CD3+CD4+T cells,CD3+CD8+T cells,CD3+CD4+/CD3+CD8+T cells and CD3+CD16+CD56+T cells.Clinical data of patients were collected,including age,sex,body mass index(BMI),tumor staging,tumor size and pathology type.Results There were no significant differences in the sex,age and BMI between renal carcinoma patients and healthy volunteers in the results of flow cytometry(P＞0.05).Significant differences were detected in the peripheral CD3+CD4+T cells,CD3+CD8+T cells,CD3+CD4+/CD3+CD8+T cells,natural killer(NK)cells,Tregs,polymorphonuclear MDSCs(PMN-MDSCs)and monocytic MDSCs(M-MDSCs)between groups(P＜0.05).Specifically,renal carcinoma patients had significantly lower levels of CD3+CD4+T cells and CD3+CD8+T cells,but higher levels of Tregs,PMN-MDSCs and M-MDSCs than those of healthy volunteers(P＜0.05).Peripheral CD3+CD4+T cells,CD3+CD8+T cells,CD3+CD4+/CD3+CD8+T cells,NK cells,Tregs,PMN-MDSCs and M-MDSCs in renal carcinoma patients did not correlate with the sex,age,BMI and pathological type(P＞0.05).CD3+CD8+T cells,CD3+CD4+/CD3+CD8+T cells and NK cells did not correlate with tumor size and staging of renal carcinoma(P＞0.05).CD3+CD4+T cells,M-MDSCs,PMN-MDSCs and Tregs were significantly correlated with tumor size and staging of renal carcinoma(P＜0.05).Logistic regression showed that low peripheral CD3+CD4+T cells and high levels of Tregs,PMN-MDSCs and M-MDSCs were significantly correlated with tumor staging of renal carcinoma.In the ROC curves,staging Ⅰ-Ⅱ renal carcinoma was denoted as 0,and staging Ⅲ-Ⅳ was denoted as 1.The AUC of serum Tregs,PMN-MDSCs and M-MDSCs in diagnosing stage Ⅲ-Ⅳ renal carcinoma was larger than 0.70,showing an acceptable diagnostic potential.Compared with the reference line,ROC curves of Tregs,PMN-MDSCs,M-MDSCs,M-MDSCs+Tregs and PMN-MDSCs+Tregs in diagnosing renal carcinoma was significantly different,especially the combined detection of PMN-MDSCs plus Tregs.Conclusion Renal carcinoma patients have significantly lower levels of CD3+CD4+T cells,CD3+CD8+T cells and CD3+CD16+CD56+T cells,but higher CD4/CD8,PMN-MDSCs,M-MDSCs and Tregs than healthy volunteers,suggesting an impaired immune function.CD3+CD4+T cells,PMN-MDSCs,M-MDSCs and Tregs vary by tumor size and staging of renal carcinoma.Peripheral levels of PMN-MDSCs,M-MDSCs and Tregs are higher in patients with larger tumor size and more advanced tumor staging of renal carcinoma.The correlation of peripheral MDSCs and Tregs with tumor staging of renal carcinoma suggests the value of them in predicting the onset,progression and prognosis of renal carcinoma.
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