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微创与开放乳腺癌手术的比较:基于术后免疫功能的倾向评分匹配研究。

Comparison of minimal access and open breast surgery: a propensity score-matched study on postoperative immune function in breast cancer.

机构信息

Department of Breast Surgery, Third Hospital of Nanchang, No. 2, Xiangshan South Road, Xi hu District, Nanchang City, Jiangxi Province, China.

Jiangxi Province Key Laboratory of Breast Diseases, Third Hospital of Nanchang, No. 1268, Jiuzhou Street, Chaoyang New Town, Xihu District, Nanchang City, Jiangxi Province, China.

出版信息

World J Surg Oncol. 2024 Jul 16;22(1):183. doi: 10.1186/s12957-024-03447-w.

Abstract

BACKGROUND

Minimal access breast surgery (MABS) is commonly employed in the management of breast cancer, but there is limited research on the postoperative immune function associated with MABS.

OBJECTIVE

This study aimed to assess the postoperative immune function in breast patients who underwent MABS or conventional open breast surgery (COBS).

METHODS

We retrospectively analyzed the medical records of 829 breast cancer patients treated with either MABS or COBS at a single hospital between January 2020 and June 2023. Among them, 116 matched pairs were obtained through 1:1 propensity score matching (PSM). Flow cytometry was used to measure the percentages of CD3, CD4, and CD8 cells, as well as the CD4/CD8 ratio, on three different time points: preoperative day 1 (PreD1), postoperative day 1 (PostD1), and postoperative day 7 (PostD7).

RESULTS

Both the MABS and COBS groups demonstrated a significant reduction in the percentages of CD3, CD4, and CD8 cells, along with the CD4/CD8 ratio, from PreD1 to PostD1. Interestingly, the MABS group showed a reversal of these parameters, returning to preoperative levels by PostD7. Conversely, the COBS group showed an increase in these parameters from PostD1 to PostD7, but they still remained significantly lower than preoperative levels at PostD7.

CONCLUSION

MABS treatment may result in reduced postoperative immune suppression and faster recovery of preoperative immune function compared to COBS in patients.

摘要

背景

微创乳房手术(MABS)常用于乳腺癌的治疗,但关于 MABS 术后免疫功能的研究有限。

目的

本研究旨在评估接受 MABS 或传统开放乳房手术(COBS)的乳房患者的术后免疫功能。

方法

我们回顾性分析了 2020 年 1 月至 2023 年 6 月在一家医院接受 MABS 或 COBS 治疗的 829 例乳腺癌患者的病历。其中,通过 1:1 倾向评分匹配(PSM)获得了 116 对匹配对。采用流式细胞术在三个不同时间点(术前第 1 天(PreD1)、术后第 1 天(PostD1)和术后第 7 天(PostD7))测量 CD3、CD4 和 CD8 细胞的百分比以及 CD4/CD8 比值。

结果

MABS 组和 COBS 组从 PreD1 到 PostD1 ,CD3、CD4 和 CD8 细胞的百分比以及 CD4/CD8 比值均显著降低。有趣的是,MABS 组这些参数在术后第 7 天恢复到术前水平。相反,COBS 组从 PostD1 到 PostD7 这些参数增加,但仍明显低于 PostD7 术前水平。

结论

与 COBS 相比,MABS 治疗可能导致术后免疫抑制减轻,且患者术前免疫功能恢复更快。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee71/11251114/41b0ff48c155/12957_2024_3447_Fig1_HTML.jpg

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