The state of the immune system in patients with leukoplakia and squamous cell carcinoma of the oral mucosa

Karpuk N.A., Ishchanka A.U.

Vitebsk State Medical University, Vitebsk, Belarus

One of the pathogenetic stages in the malignant transformation of oral mucosa (OM) is the disruption of proliferation and differentiation of the epithelium with the development of low-grade squamous intraepithelial lesions (LSIL). The study of the immune status of patients with oral squamous cell carcinoma (OSCC) and oral leukoplakia (OL), taking into account the morphological heterogeneity, is a very relevant scientific direction.
The aim of the study was to assess the immune status of patients with OL while accounting for morphological heterogeneity, and to identify differences between patients with OSCC and healthy individuals.
Material and methods. The study was conducted in accordance with the open cohort study protocol. The study included patients with IL (n=66) and OSCC (n=33). The comparison group consisted of healthy volunteers (n=30). Patients with IL were divided into groups: patients with LSIL (n=34) and without (n=32).
Conclusions. The examined patients with OL and LSIL showed signs of dysfunction of the immune system, namely a decrease in the number of cytotoxic T CD8+CD69+ lymphocytes and an increase in the level of IL-18 compared to the OL group without LSIL and healthy individuals.
In patients with OSCC, significant changes in the immune status were revealed: a decrease in the number of cytotoxic T CD8+CD69+ lymphocytes and B lymphocytes with expression of the costimulating receptor CD19+CD40+ with an increase in the levels of CD14+ monocytes; CD34+CD45- cells and high serum levels of proinflammatory cytokines were detected in the peripheral blood: IL-1ß, IL-6, IL-18, MCP-1.
In patients with OL without LSIL, no significant changes in the studied systemic indicators of immune status were detected.