Relationship between psychoncology and psychoneuroendocrinoimmunology (PNEI): Enhanced T-regulatory lymphocyte activity in cancer patients with self-punishement, evaluated by Rorschach test

Background: Psychological studies have documented the presence of a self-punishment profile in cancer patients. Recent immuno-oncological studies have shown that within the group of CD4⁺ cells, which play a fundamental role in the generation of anticancer immunity, there is a subtype of cells that in contrast mediates the suppression of the anticancer immunity, the so-called T-regulatory cells (T-reg), which may be identified as CD4 ⁺CD25⁺ cells. Patients and Methods: On this basis, we performed a psychoncological study to evaluate CD4⁺CD25⁺ cell numbers in relation to the response to Rorschach's test in a group of 30 cancer patients suffering from the most frequent tumor histotypes. Results: Normal values obtained in our laboratory (95% confidence limits) of T-reg lymphocytes and CD4⁺/CD4⁺CD25⁺ were 3 and >4mm³, respectively. The psychological profile of self-punishment was found in 18/30 patients (60%). The percentage of patients with abnormally high CD4⁺CD25⁺ values observed in the group with self-punishment was significantly higher than that found in patients without self punishment (11/18 vs. 3/12 (25%), p+/CD4 ⁺CD25⁺ ratios was significantly higher in the group with self-punishment (16/18 vs. 4/12, p+/ CD4 ⁺CD25⁺ ratio was significantly lower in patients with self-punishment than in the other group (2.6±02 vs. 5.2±0.8, p+ lymphocytes. Conclusion: The study suggests that self-punishment may inhibit the generation of an effective anticancer immune response by stimulating the activation and proliferation of T-reg lymphocytes, which in turn stimulate tumor dissemination by suppressing anticancer immunity. The abnormally high number of T-reg lymphocytes in patients with self-punishment would suggest a specific immune alteration, as suggested by the evidence of a normal profile for other immune parameters, such as total CD4⁺ lymphocytes.