Aim: The aim of our prospective non-randomised study was to evaluate the influence of surgery and radiotherapy of advanced oral squamous cell carcinoma on complete blood count, acute inflammatory response and subpopulations of lymphocytes in peripheral blood.

Patients and methods: Venous blood samples were obtained from 22 patients with advanced oral squamous cell carcinomas treated with radical surgery and external beam radiotherapy. Blood samples were collected prior to surgery (T1), after surgery (T2), after radiotherapy (T3) and one year after radiotherapy (T4). Blood samples were analyzed for whole blood count, inflammatory response markers, levels of T, B lymphocytes, NK cells, CD64 and CD163 index on lymphocytes, neutrophils and monocytes, CD4/CD8 ratios and levels of naïve and memory T lymphocytes.

Results: Surgery caused anemia, thrombocytosis, leukocytosis, lymphopenia, rise in acute inflammatory phase proteins. After radiotherapy hemoglobin, leukocytes, C-reactive protein, erythrocyte sedimentation rate, albumin and proteins returned almost to T1 levels while levels of T, B lymphocytes, naïve T lymphocytes and CD4/CD8 ratios lowered. One year after radiotherapy levels of whole lymphocytes, T lymphocytes, naïve T lymphocytes, CD4/CD8 ratios and indexes remained lowered, while levels of hemoglobin, trombocytes and liver enzymes returned to normal values. Levels of NK cells remained elevated.

Summary: Surgery caused a significantly stronger acute phase response than radiotherapy, while radiotherapy caused lowering of levels of T and B lymphocytes, naïve T lymphocytes as well as CD4/CD8 ratios. Levels of T lymphocytes, naïve T lymphocytes, CD4/CD ratios and CD64 and CD163 indexes remained lowered even a year after radiotherapy.

Conflict of interest: None declared.