Clinical Roles of Increased Populations of Foxp3+CD4+ T Cells in Peripheral Blood from Advanced Pancreatic Cancer Patients

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Abstract
Further metastasis should be avoided in pancreatic cancer (PC) patients for effective surgical treatment. Regulatory T cells (Foxp3+CD4+ T cells including CD4+CD25+ T cells and CD4+CD25− T cells) play important roles in tumor immunity. This study aimed to investigate whether regulatory T cells participate in metastasis. Peripheral blood was withdrawn from PC patients, as well as healthy volunteer donors as controls. The peripheral blood mononuclear cells (PBMCs) were subjected to FACScan analysis after labeling with anti-CD4, anti-CD25, and anti-Foxp3 antibodies. Tumor markers, including DUPAN2 and CA19-9, surface markers, such as the CD4/CD8 ratio, and the CD57+ cell population were assessed. Clinical stages were classified according to the TNM classification. The Foxp3+CD4+ T-cell population among the PBMCs was significantly increased in PC patients (8.10% ± 4.65%) compared with healthy donors (2.47 ± 0.78%) (P < 0.001). No significant relationships existed for the tumor markers, CD4/CD8 ratio, and CD57+ cells. However, a significant correlation was found between Foxp3+CD4+ T cells among the PBMCs and the TNM stage (P < 0.05). Foxp3+CD4+ T cells are good markers for metastasis detection in PC patients and more accurate than other conventional tumor markers, especially at advanced stages of the disease.