Rubinkiewicz Mateusz, Siemińska Izabela, Małczak Piotr, Major Piotr, Baran Jarosław, Budzyński Andrzej, Pędziwiatr Michał
12 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland; 2Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland; 3Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland.
Acta Clin Croat. 2019 Jun;58(2):337-342. doi: 10.20471/acc.2019.58.02.18.
Surgical procedure has immense impact on the immune balance. However, little is known about perioperative changes in T regulatory and Th17 lymphocyte subpopulations in patients undergoing colorectal resection. Patients with resectable colon cancer were enrolled in the study. Blood samples were obtained on two occasions, i.e. before the procedure and two days after the surgery. We also recruited a control group of young, healthy individuals. Lymphocyte subpopulations were analyzed with the use of flow cytometry. Investigated subpopulations consisted of total lymphocyte count, CD4+, CD8+, T regulatory Foxp3+ (Tregs), Th17 lymphocytes and white blood cell (WBC) count. There were significant differences in immune cell levels before and after the surgery. Reduction was recorded in the CD4+, CD8+, Tregs and total lymphocyte counts (p=0.002, p=0.01, p=0.008 and p=0.001, respectively). Increase was observed in total WBC and Th17 cells, however, Th17 lymphocytes did not reach statistical significance (p=0.01 and p=0.5, respectively). In conclusion, surgical intervention caused changes in all lymphocyte subpopulations investigated in patients undergoing surgery for colorectal cancer. However, it seemed to be an effect of perioperative trauma. Further studies are needed to investigate the impact of surgical intervention on lymphocyte subpopulations.
手术操作对免疫平衡有巨大影响。然而，关于接受结直肠切除术患者围手术期调节性T细胞和Th17淋巴细胞亚群的变化，我们知之甚少。本研究纳入了可切除结肠癌患者。在两个时间点采集血样，即手术前和手术后两天。我们还招募了一组年轻健康的个体作为对照组。使用流式细胞术分析淋巴细胞亚群。所研究的亚群包括总淋巴细胞计数、CD4 +、CD8 +、调节性T细胞Foxp3 +（Tregs）、Th17淋巴细胞和白细胞（WBC）计数。手术前后免疫细胞水平存在显著差异。CD4 +、CD8 +、Tregs和总淋巴细胞计数均有所下降（分别为p = 0.002、p = 0.01、p = 0.008和p = 0.001）。总白细胞和Th17细胞有所增加，然而，Th17淋巴细胞未达到统计学显著性（分别为p = 0.01和p = 0.5）。总之，手术干预导致了接受结直肠癌手术患者所研究的所有淋巴细胞亚群发生变化。然而，这似乎是围手术期创伤的结果。需要进一步研究来探讨手术干预对淋巴细胞亚群的影响。
