Immune disorders after combined treatment of obese patients with endometrial cancer

Immune disorders in antitumor treatment of obese patients may depend on the severity of the inflammatory process, which justifies the need to take into account the intensity of the latter in the analysis of complications of antitumor treatment in obese individuals. Purpose – evaluation of immune disorders after radiation therapy in obese patients with different intensity of the inflammatory process. Materials and methods. 65 patients with stage I–II endometrial cancer underwent pangysterectomy and a postoperative course of remote gamma therapy. Examinations were performed before treatment and after radiation therapy. Subpopulation composition of lymphocytes, phagocytic activity of neutrophils, levels of circulating immune complexes and immunoglobulins G, A, M were determined by standard methods. The SF-3000 «SYSMEX» analyzer was used to evaluate hematological parameters. The level of Creactive protein (CRP) was determined using an analyzer «RESPONS 910». Insulin and leptin levels were assessed by enzyme-linked immunosorbent assay. Results and discussion. Immune and hematological parameters were evaluated in 3 groups of patients. Group I included patients with normal body weight (BMI < 25), II and III groups consisted of obese patients (BMI > 30). Group II included patients with a CRP level below the median, which was 18,0 mg/l, group III – patients with a CRP level above 18.0 mg/l. In patients of group II there was a higher absolute and relative number of lymphocytes, the absolute number of CD3+-, CD4+- and CD8+-lymphocytes compared with those registered in groups I and III. After radiation therapy, the absolute number of lymphocytes and lymphocyte subpopulations decreased in all groups. As before treatment, higher levels of these indicators were registered in group II. In obese patients, the relative number of NK cells was lower than that determined in patients of group I before and after treatment. Conclusions. Patients with obesity and low intensity of the inflammatory process have less pronounced immune disorders after radiation therapy compared with patients who had a normal body weight and individuals with obesity and high levels of CRP. (author)