Presence of activated T lymphocytes in peripheral blood of head and neck squamous cell carcinoma patients predicts impaired prognosis

Hans Jørgen Aarstadab*, John-Helge Heimdalab, Beate Klementsena, Jan Olofssonab & Elling Ulvestadca Department of Surgical Sciences, Section of Otolaryngology/Head and Neck Surgery, Faculty of Medicine, University of Bergen, Bergenb Division of Head and Neck Diseases, Bergen, Norwayc Department of Microbiology and Immunology, Haukeland University Hospital, Bergen, Norway† Correspondence: Hans Jørgen Aarstad, Department of Otolaryngology/Head & Neck Surgery, Haukeland University Hospital, 5021, Bergen, Norway, +47 55974956 hans.aarstad@ore.uib.noConclusions. The results indicate that a high level of peripheral blood (PB) T-lymphocyte activation in vivo predicts impaired prognosis with and without adjustment for TNM stage in head and neck squamous cell carcinoma (HNSCC). Objective. To determine if PB T-lymphocyte activation in vivo is associated with the presence of, stage of and prognosis of HNSCC. Materials and methods. Sixty-two patients with newly diagnosed HNSCC and 15 control patients were studied. PB T-lymphocyte activation was assessed by measuring by flow cytometry the percentage of PB T lymphocytes (CD3 + ) showing the early activation-related cell surface epitopes CD69+ or CD71+ (transferrin receptor) or the late activation epitopes CD25+ (IL-2 receptor) or HLA-DR+. Results. There was no significant difference in expression of T-lymphocyte activation markers between HNSCC patients and control patients, or any difference dependent on TNMG stage. In HNSCC patients a high percentage of CD71+ T lymphocytes predicted worse prognosis with a relative risk (RR) of 2.38 (confidence interval (CI): 1.04–5.47). A high mean value of the early (CD69 + /CD71 + ) (RR 2.37; CI: 1.06–5.29) or late (CD25 + /HLA-DR + ) (RR 3.31; CI: 1.39–7.88) activation markers also predicted worse prognosis. Following adjustment for TNM stage, high mean value of the early activation epitopes CD71+ (RR 2.89; CI: 1.22–6.85), the mean value of CD69 + /CD71+ (RR 2.58; CI: 1.12–5.91) and CD25 + /HLA-DR+ (RR 2.75; CI: 1.14–6.62) predicted worse prognosis.