Circulating lymphocytes in Relation to Long-term Clinical Outcome in Patients with Prostate Cancer

Abstract

Background: The clinical outcomes of prostate cancer (PC) may involve changes in immune profiles. Whether long-term prognosis of PC is related to circulating lymphocytes is still uncertain. Therefore, we investigated the long-term prognostic value of different lymphocyte populations in PC. Materials: Patients with a pathological diagnosis of PC, at the Gleason Grades of 5 to 10 were included in the prospective cohort study. Lymphocyte count was evaluated in peripheral blood by flow cytometry. The prognostic value of different lymphocytes was analyzed in the whole cohort and the Kaplan-Meier method and Cox regression models were used for survival curves and multivariate analysis, respectively. Results: Between January 2001 and June 2021, 94 evaluable patients with prostate cancer were prospectively enrolled. The median follow-up duration of the study was 98 months. The levels of the CD4(+)/CD8(+) ratio, CD19(+), and CD19(+)CD5(−) B lymphocytes in non-survivors were lower than those in survivors. Grouping by each cutoff point of the lymphocytes respectively, the lower level of total CD3(+) T cells, CD3(+)CD4(+) T cells, the CD4(+)/CD8(+) ratio, total CD19(+) B cells, CD19(+)CD5(+) B cells, CD19(+)CD5(-) B cells showed poor survival. Multivariate Cox regression analysis confirmed the worse prognosis associated with higher PSA (HR=2.493, 95%CI: 1.356-4.584, P=0.003), lower CD3(+)CD4(+) T lymphocytes (HR=0.379, 95%CI: 0.170-0.843, P=0.017), lower total CD19(+) B cell (HR=0.398, 95%CI:0.187-0.845, P=0.016) and higher CD3(-)CD16(+)CD56(+) NK cells(HR=2.355, 95%CI: 1.175-4.723, P=0.016). Conclusion: Our results showed that low level of CD4(+) T lymphocytes, decreased CD19(+) B cell and high level of NK cells were correlated with poor survival, which indicates that B lymphocytes, CD4(+) T lymphocytes and NK cells might involve in prostate cancer and associated with the long-term prognosis of this elderly patients.