Aims. Lymph node involvement is an independent marker of worse outcome for patients with head and neck cancer (HNC). Immune suppression is thought to be a major contributor to tumour progression and thus characterising the immune response may identify biomarkers of prognosis. CD4/CD8 ratios have been postulated as a potential surrogate marker for immune suppression and activation in cancer but their utility is not clear in HNC. This study investigates the relationship between peripheral blood CD4/CD8 ratios and clinicopathological variables in a cohort of patients with oral cavity squamous cell carcinoma (OCSCC).
Methods. Peripheral blood mononuclear cells (PBMCs) were isolated from OCSCC (n=10 node positive, n=13 node negative, n=4 recurrent/metastatic) patients pre-treatment and analysed via conventional flow cytometry. Correlative clinicopathological data was collected for all patients. Statistical analysis was performed using RStudio (version 1.1.423).
Results. OCSCC patients stratified by nodal involvement status showed statistically significant differences in CD4/CD8 ratio. Patients with nodal involvement had a mean CD4/CD8 ratio of 5.01±0.91 compared to node negative patients who had a mean CD4/CD8 ratio of 2.45±0.38 (p=0.02). Stratified by TNM stage, mean CD4/CD8 ratios increased with stage but this was not significant (stage I 2.47±0.73; stage II 3.11±0.67; stage III 5.00±0; stage IV 4.34±0.87).
Conclusions. CD4/CD8 ratios were significantly higher in patients with lymph node involvement. Although not statistically significant, the association between a higher CD4/CD8 ratio and more advanced TNM stage aligns with this key finding. Continued follow-up of these patients is required for survival analysis but a significant correlation with nodal involvement highlights the potential utility of the CD4/CD8 ratio.