TGF-beta 1 levels are associated with lymphocyte percentages in patients with lung cancer treated with radiation therapy

Figures & data

Table 1 Clinical characteristics and TGF-β1 levels (ng/mL) of the 82 patients

	n	TGF-β1a	P-valuea	TGF-β1b	P-valueb
Gender			0.827		0.274
Male	51	2.81±0.42		2.52±0.47
Female	31	3.02±1.07		3.81±1.37
Age (years)			0.483		0.093
≥65	30	3.32±0.83		4.13±1.30
<65	52	2.69±0.45		2.33±0.43
Histological type			0.078		0.247
SCLC	21	2.74±0.46		2.83±0.67
Adenocarcinoma	30	1.57±0.18		4.68±1.68
SCC	30	3.41±0.83		2.41±0.65
Others	1	1.30		1.48
Stage			0.053		0.389
I	1	1.14		0.81
II	36	3.31±1.68		2.14±0.64
III	41	2.55±0.36		2.90±0.58
IV	4	4.40±1.65		3.22±1.70
Radiation dose, Gy			0.362		0.858
≥60	76	2.80±0.40		2.80±0.48
<60	6	5.08		2.26
Chemotherapy cycles			0.098		0.017
≥4	46	2.40±0.38		2.01±0.37
<4	36	3.77±0.85		4.35±1.10

Notes:

a Pre-RT.

b Post-RT. TGF-β1 levels did not show statistical significance of the 82 patients in different clinical characteristics.

Abbreviations: RT, radiation therapy; SCC, squamous cell carcinoma; SCLC, small-cell lung cancer.

Table 2 TGF-β1 levels (ng/mL) of the 82 lung cancer patients at 4 timepoints by treatment efficacy

	SCLC			NSCLC
	CR+PR	SD+PD	P-value	CR+PR	SD+PD	P-value
Subjects, n	12	9	–	35	26	–
Pre-RT	2.80±0.43	2.66±0.95	0.81	2.70±0.84	3.42±1.16	0.61
During RT
2 weeks	2.39±0.44	1.78±0.27	0.30	2.77±0.84	4.13±1.24	0.35
4 weeks	2.31±0.74	2.50±0.80	0.87	1.76±0.54	4.21±1.17	0.048
Post-RT	1.51±0.12	4.59±1.40	0.02	1.70±0.22	4.37±1.53	0.025

Note: In both SCLC and NSCLC patients, the TGF-β1 levels before RT were comparable, patients who experienced an effective response (CR+PR) also had a significantly lower mean TGF-β1 level after RT compared with whom RT was ineffective (SD+PD).

Abbreviations: CR, complete response; NSCLC, non-small-cell lung cancer; PD, progressive disease; PR, partial response; SCLC, small-cell lung cancer; RT, radiation therapy; SD, stable disease.

Table 3 Patients (n) with TGF-β1 levels at various timepoints after RT (with reference to pre-RT levels) by treatment response

Fold changea	SCLC		NSCLC
	Effective	Ineffective	Effective	Ineffective
2 weeks
<1	9	4	25	9
>1	3	5	10	17
4 weeks
<1	10	5	27	9
>1	2	4	8	17
Post-RT
<1	11	3	25	5
>1	1	6	10	21

Notes:

a Relative to pre-treatment TGF-β1 levels. The majority (36/47) of patients who had an effective response, TGF-β1 levels experienced a drop after RT compared with pre-RT levels. The TGF-β1 levels of most of the patients who showed an ineffective response (27/35) were higher after RT relative to pre-RT.

Abbreviations: NSCLC, non-small-cell lung cancer; RT, radiation therapy; SCLC, small-cell lung cancer.

Table 4 TGF-β1 levels and lymphocyte percentages of 82 patients at 4 timepoints

	Pre-RT	During RT		Post-RT
		2 weeks	4 weeks
TGF-β1, ng/mL	2.81±0.38	2.85±0.40	2.51±0.39	2.74±0.46
Lymphocytes, %
CD3^+ T cells	69.11±1.71	68.60±1.81	65.63±1.64a	62.55±1.82a
CD4^+ T cells	38.88±1.45	39.44±1.67	40.78±1.81	40.70±2.18
CD8^+ T cells	26.45±1.52	28.00±1.69	26.73±1.39	30.23±2.56b
CD4^+/CD8^+	1.67±0.11	1.65±0.13	1.75±0.12	1.89±0.19
B cells	9.33±0.64	6.27±0.41a	7.35±0.68b	4.21±0.35a
NK cells	20.73±1.54	21.41±1.59	21.04±1.71	20.41±1.58

Notes:

a Compared with pre-RT, P<0.01;

b compared with pre-RT, P<0.05. The TGF-β1 levels decreased only slightly from pre-RT to post-RT, and the percentages of CD3⁺ T cells and B cells were significantly lower at post-RT. In addition, compared with pre-RT levels, at post-RT the CD4⁺ T cells and the CD4⁺/CD8⁺ ratio were only slightly higher; CD8⁺ T cells were higher; and NK cells remained stable.

Abbreviations: NK, natural killer; RT, radiation therapy.

Table 5 Associations between TGF-β1 levels and lymphocyte percentages

	During RT
	2 weeks		4 weeks		Post-RT
	r	P-value	r	P-value	r	P-value
CD3^+ T cells	−0.117	0.478	−0.006	0.973	0.250	0.125
CD4^+ T cells	−0.581	0.023	−0.516	0.037	−0.648	<0.001
CD8^+ T cells	0.558	0.041	0.545	0.011	0.626	<0.001
CD4^+/CD8^+	−0.615	0.024	−0.648	0.003	−0.598	<0.001
B cells	0.042	0.8	0.056	0.736	0.132	0.424
NK cells	−0.301	0.063	−0.292	0.073	−0.298	0.066

Notes: At the second and fourth weeks during RT, and at the end of RT, TGF-β1 levels were significantly associated with the percentages of CD4⁺ T cells; CD8⁺ T cells; and the CD4⁺/CD8⁺ ratio. There were no significant associations between TGF-β1 levels and percentages of CD3⁺ T cells, B cells, or NK cells.

Abbreviations: NK, natural killer; r, correlation coefficient; RT, radiation therapy.