结直肠癌与良性疾病腹腔镜手术中细胞免疫反应与免疫生物标志物的比较

Surgical trauma causes immune impairment, but it is largely unknown whether surgery for cancer and benign diseases instigate comparable levels of immune inhibition. Here, we compared the impact of laparoscopic surgery on immunological biomarkers in patients with colorectal cancer (CRC) and ventral hernia (VH).

Natural Killer cell activity (NKA), leukocyte subsets, and soluble programmed death ligand 1 (sPD-L1) were measured in blood samples collected from CRC (n = 29) and VH (n = 9) patients preoperatively (PREOP) and on postoperative day (POD) 1, 3-6, 2 weeks and 3 months. NKA was evaluated by the NK Vue assay that uses the level of IFN as a surrogate marker of NKA. Normal NKA was defined as IFN > 250 pg/mL and low NKA was defined as IFN < 250 pg/mL.

The CRC cohort was classified into either PREOP LOW having preoperative low NKA or PREOP HIGH having preoperative normal NKA. The median NKA of the PREOP LOW subset was only in the normal range in the POD3 months sample, whereas median NKA of the PREOP HIGH subset and the VH cohort were only low in the POD1 sample. While PREOP LOW differed from VH in the PREOP-, POD1-, and POD3-6 samples (P =.0006, P = .0181, and P = .0021), NKA in PREOP HIGH and VH differed in the POD1 samples (P = .0226). There were no apparent differences in the distribution of leukocyte subsets in the perioperative period between the cohorts.

CRC patients with preoperative normal NKA and VH patients showed the same pattern of recovery in NKA, while the CRC subset with preoperative low NKA seemed to experience prolonged NK cell impairment. As low NKA is associated with recurrence, preoperative level of NKA may identify patients who will benefit from immune-enhancing therapy in the perioperative period.