- 作者：Cristina Falci ; Ketty Gianesin ; Giuseppe Sergi ; Silvia Giunco ; Irene De Ronch ; Sara Valpione ; Caterina Sold脿 ; Pasquale Fiduccia ; Sara Lonardi ; Marisa Zanchetta ; Sonia Keppel ; Antonella Brunello ; Valeria Zafferri ; Enzo Manzato ; Anita De Rossi ; Vittorina Zagonel
- 关键词：CGA ; comprehensive geriatric assessment ; MPI ; multidimensional prognostic index ; RTE ; recent thymic emigrant ; TREC ; T-cell receptor rearrangement excision circle ; RU ; relative units ; ADL ; Activities of Daily Living ; IADL ; Instrumental Activities of Daily Living ; SPMSQ ; Short Portable Mental Status Questionnaire ; MMSE ; Mini Mental Status Examination ; CIRS-CI ; Cumulative Illness Rating Scale-Comorbidity Index ; CIRS-SI ; Cumulative Illness Rating Scale-Severity Index ; GDS ; Geriatric Depression Scale
- 刊名：Experimental Gerontology
- 出版年：December, 2013
- 年：2013
- 卷：48
- 期：12
- 页码：1436-1442
- 全文大小：428 K
Background
The challenge of immune senescence has never been addressed in elderly cancer patients. This study compares the thymic output and peripheral blood telomere length in 鈮?#xA0;70 year old cancer patients.Patients and methods
Fifty-two elderly cancer patients and 39 age-matched controls without personal history of cancer were enrolled. All patients underwent a Comprehensive Geriatric Assessment (CGA), from which a multidimensional prognostic index (MPI) score was calculated. Peripheral blood samples were studied for na茂ve and recent thymic emigrant (RTE) CD4+ and CD8+ cells by flow cytometry. T-cell receptor rearrangement excision circle (TREC) levels, telomere length and telomerase activity in peripheral blood cells were quantified by real-time PCR.
Results
The percentages of CD8+ na茂ve and CD8+ RTE cells and TREC levels were significantly lower in cancer patients than in controls (p = 0.003, p = 0.004, p = 0.031, respectively). Telomere lengths in peripheral blood cells were significantly shorter in cancer patients than in controls (p = 0.046) and did not correlate with age in patients, whereas it did in controls (r = 鈭?#xA0;0.354, p = 0.031). Short telomere (鈮?#xA0;median)/low TREC (鈮?#xA0;median) profile was associated with higher risk of cancer (OR = 3.68 [95% CI 1.22-11.11]; p = 0.021). Neither unfitness on CGA nor MPI score were significantly related to thymic output or telomere length in either group.
Conclusions
Immune senescence is significantly worse in elderly cancer patients than in age-matched controls. The low thymic output and the shorter telomeres in peripheral blood cells of cancer patients may reflect a pre-existing condition which facilitates the onset of malignancies in elderly people.