LYMPHOCYTE SUBPOPULATIONS IN GASTRIC AND COLORECTAL CANCER PATIENTS AFTER IMMUNOTHERAPY WITH ACTIVATED LYMPHOCYTES

Phenotyping of peripheral blood lymphocytes and immune activation markers of activation (HLADR, CD38, CD69, CD314, CD25) was performed in thirteen patients with disseminated forms of stomach and rectal cancer before cell treatment, and following adoptive immunotherapy with activated lymphocytes. It wasshown that the lymphocytes are well activated and are able to proliferate in vitro. It was revealed that the relative content of Tregs and NK cells is increased in these patients. After the courses of immunotherapy, initially low levels of B-cells (average 5%) remained in all the patients, whereas concentration of Тregs didn’t change. Increased expression of activation markers was revealed for all lymphocyte subsets (CD25, CD314, CD38, HLA-DR) and, especially, for T-lymphocytes (CD3+HLA-DR, CD3+CD38+). Significant decrease of T helpers, activated NK-cells (CD16+CD314+) and CD4+/CD8+ was noted in peripheral blood. A non-significant elevation in mature lymphocytes (CD45RO+) and reduced content of young lymphocytes (CD45RA+) were revealed. Adoptive immunotherapy is safe and well tolerated, being characterized by lack of side effects, and it may be recommended as a complement to conventional radio- and chemotherapy

CANCER-EMBRYONIC ANTIGEN IN PREDICTING THERAPEUTIC TUMOR PATHOMORPHISM AFTER NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH RECTAL CANCER

The purpose of the study was to evaluate the prognostic significance of carcinoerembryonic antigen in patients with rectal cancer and correlate its baseline with the degree of therapeutic pathomorphosis after neoadjuvant chemoradiotherapy.Materials and methods. An estimate of the informative value of carcinoerembryonic antigen (CEA) indices in 179 patients with colorectal cancer determined before and after preoperative chemoradiotherapy (CRT) in SOD 50 Gy.Results. Analysis of the results presented in the study showed that in all patients, CRT caused a significant decrease in the level of CEA (–71%) 10 weeks after its end (p < 0.001). In the course of the pathomorphological study, after the neoadjuvant treatment, the first degree of tumor pathomorphism was recorded in 4.5% of patients, II – 38.5%, III – 45%, IV – 12% (the degree of pathomorphosis is not related to the clinical stage and the degree of differentiation of colorectal cancer). It was revealed that patients with III and IV degrees of therapeutic pathomorphosis initially had a CEA level lower, in comparison with patients with grade I-II. Clinical progression of the disease is diagnosed in 24% of cases (43/179). It was noted that in patients with the IV degree of therapeutic pathomorphism of the tumor, no recurrence of the rectal cancer was detected in either case.Conclusion. The results of the study showed that the problem of individual prediction of the effectiveness of combined treatment of the rectal cancer remains very relevant, rather complicated and yet not completely solved. However, it can be assumed that the use of such an indicator as CEA in monitoring patients after the treatment, can serve as a criterion for the sensitivity of colorectal cancer to CRT. Initially low antigen level can be considered as a positive factor of tumor response to ongoing treatment and disease-free survival of patients with locally advanced rectal cancer