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T lymphocyte subsets and Th1/Th2 balance after laparoscopy-assisted distal gastrectomy
1Department of Surgery I, Oita Medical University, Oita 879-5593, Japan. kyufujii@oita-med.ac.jp
Background:
Laparoscopic surgery provides for a less invasive procedure than open surgery in patients with gastric cancer, but the immune responses after laparoscopic surgery for early gastric cancer remain unknown.
Methods:
Peripheral blood mononuclear cells from 20 patients with early gastric cancer who underwent laparoscopy-assisted distal gastrectomy (LADG) or open distal gastrectomy (ODG) were obtained; the cell surface molecules and intracellular cytokines (IFN-gamma and IL-4) were measured by flow cytometry.
Results:
The populations of T lymphocytes after LADG, including CD3-, 4-, 8-, 57-, and HLA-DR-positive lymphocytes, showed patterns similar to those after ODG. The production of IFN-gamma as Th1 cell function decreased significantly on the third postoperative day after ODG but increased after LADG. The production of IL-4, representing Th2 cell function, increased postoperatively after ODG but not after LADG.
Conclusions:
When compared with ODG, LADG contributes to the preservation of postsurgical Th1 cell-mediated immune function.