Department of Anesthesiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, China.
Department of Anesthesiology, Fujian Medical University Union Hospital, China.
Biomed Res Int. 2020 Mar 16;2020:2101480. doi: 10.1155/2020/2101480. eCollection 2020.
Immune dysfunction can occur after neoadjuvant chemotherapy (NAC) and surgery for cancer. We investigated whether preoperative oral carbohydrate affected the postoperative percentages of T cells (CD4 and CD8) and natural killer (NK) cells in patients with cervical cancer treated with NAC and surgery.
This prospective cohort study enrolled consecutive patients with cervical cancer treated by radical hysterectomy with PLND at the Gynecologic Oncology Department of Fujian Provincial Cancer Hospital (China) between January 2018 and December 2018. Patients were divided into three groups according to the treatment method: NAC (two cycles, surgery 1 month later), NAC+CHO (chemotherapy and surgical methods same as with the NAC group but with 300 mL of oral carbohydrate administered 2 h before surgery), and non-NAC (surgery alone). Percentages of NK, CD3, CD4, and CD8 cells were evaluated by flow cytometry the day after the first admission, just before surgery, immediately after tracheal tube removal, and the day after surgery. This trial is registered with NCT03872635 at clinicaltrials.com.
The final analysis included 77 patients (non-NAC group, = 26; NAC group, = 25; and NAC-CHO group, = 26). Baseline characteristics and preoperative NK, CD3, CD4, and CD8 cell percentages were similar between groups. Postoperatively, all groups exhibited reductions in NK, CD3, and CD4 cell percentages and increases in CD8 cell percentages (all < 0.05). The changes in NK, CD3, CD4, and CD8 cell percentages were attenuated in the NAC-CHO group ( < 0.05 vs. both other groups).
Preoperative oral carbohydrate can improve the postoperative populations of NK and T cells after the treatment of cervical cancer by NAC and surgery.
新辅助化疗（NAC）和手术治疗癌症后会发生免疫功能障碍。我们研究了术前口服碳水化合物是否会影响接受 NAC 和手术治疗的宫颈癌患者术后 T 细胞（CD4 和 CD8）和自然杀伤（NK）细胞的百分比。
这项前瞻性队列研究纳入了 2018 年 1 月至 2018 年 12 月期间在福建省肿瘤医院妇科肿瘤科接受根治性子宫切除术和 PLND 的连续宫颈癌患者。患者根据治疗方法分为三组：NAC（两个周期，术后 1 个月）、NAC+CHO（化疗和手术方法与 NAC 组相同，但术前 2 小时给予 300mL 口服碳水化合物）和非 NAC（单独手术）。在首次入院后第 1 天、术前、气管导管拔除后即刻以及术后第 1 天，通过流式细胞术评估 NK、CD3、CD4 和 CD8 细胞的百分比。该试验在 clinicaltrials.com 上以 NCT03872635 号注册。
最终分析纳入了 77 例患者（非 NAC 组，n=26；NAC 组，n=25；NAC+CHO 组，n=26）。各组间基线特征以及术前 NK、CD3、CD4 和 CD8 细胞百分比相似。术后各组 NK、CD3 和 CD4 细胞百分比降低，CD8 细胞百分比升高（均 P<0.05）。NAC+CHO 组 NK、CD3、CD4 和 CD8 细胞百分比的变化较小（均 P<0.05 比其他两组）。
术前口服碳水化合物可改善接受 NAC 和手术治疗的宫颈癌患者术后 NK 和 T 细胞的群体。
