Department of Gastrointestinal Surgery, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
Department of Gynaecology and Obstetrics, Jinjiang Hospital, Jinjiang, Fujian, China.
Cancer Control. 2020 Jan-Dec;27(1):1073274820906811. doi: 10.1177/1073274820906811.
Laparoscopic resection is increasingly used in colorectal cancer (CRC). It has been suggested to carry short-term benefits in safety, recovery, and preservation on immune function for patients with CRC. However, the impact of laparoscopic resection on natural killer (NK) cells is largely unclear.
A total of 200 patients with CRC across Dukes A/B/C stages were randomly assigned to laparoscopic or open resection. The blood samples were collected before and after the surgery. The total number of NK cells was quantified by flow cytometer. Lytic units 35 toward K562 was used to quantify NK cells activity. The outcomes between the groups across pathological stages were also analyzed.
The number and activity of NK cells decreased after the surgery in both groups. The laparoscopic group showed a faster recovery rate of NK cells function than the control group as assessed by cell count and lytic activity. Natural killer cells were impaired in a higher degree in patients at Dukes B/C stages. The recovery of NK cells to baseline level at day 7 postsurgery was observed in the laparoscopic group across all 3 stages.
Generally, laparoscopically assisted surgery resulted in a better preservation on NK cells function. A better outcome was observed in patients with CRC at Dukes B/C stages.
腹腔镜结直肠癌(CRC)切除术的应用日益增多。有研究表明,腹腔镜切除术对 CRC 患者的安全性、恢复和免疫功能保存具有短期优势。然而,腹腔镜切除术对自然杀伤(NK)细胞的影响尚不清楚。
本研究共纳入 200 例 Dukes A/B/C 期 CRC 患者,随机分为腹腔镜组或开腹组。分别于术前和术后采集血样,采用流式细胞术检测 NK 细胞总数,用 K562 细胞裂解单位(LUd)35 检测 NK 细胞活性。分析两组不同病理分期的患者的预后。
两组患者术后 NK 细胞数量和活性均降低。细胞计数和裂解活性检测结果表明,与开腹组相比,腹腔镜组 NK 细胞功能的恢复速度更快。Dukes B/C 期患者 NK 细胞受损程度更高。腹腔镜组患者在术后第 7 天 NK 细胞恢复至基线水平,而开腹组仅在 Dukes A 期患者中观察到这种恢复。
腹腔镜辅助手术对 NK 细胞功能具有更好的保护作用,Dukes B/C 期患者的预后更好。