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Immune profiling after minimally invasive lobectomy.

Suat Erus1, Ayşe Bilge Öztürk2, Özgür Albayrak3

  • 1Department of Thoracic Surgery, Koç University School of Medicine, Istanbul, Turkey.

Interactive Cardiovascular and Thoracic Surgery
|December 14, 2020
PubMed
Summary

Minimally invasive lung surgery impacts immune responses, with decreased interleukin-10 (IL-10) and lower lymphocyte counts post-operation. Acute phase reactants like C-reactive protein, cortisol, and glucose significantly increased, indicating a dynamic immune balance.

Keywords:
Early-stage lung cancerInterleukin 10Interleukin 8Minimally invasive surgeryNatural killerTumour necrosis factor alpha

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Area of Science:

  • Thoracic Surgery
  • Immunology
  • Oncology

Background:

  • Minimally invasive lung surgery, including video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracic surgery (RATS), is increasingly used for early-stage non-small-cell lung cancer (NSCLC).
  • The impact of these procedures on acute phase reactants and immune cell profiles requires further investigation.

Purpose of the Study:

  • To evaluate the perioperative immune profile in patients undergoing minimally invasive lobectomy for stage I NSCLC.
  • To assess changes in acute phase reactants and immune cell populations following VATS or RATS.

Main Methods:

  • A pilot study involving patients with stage I NSCLC who underwent VATS or RATS lobectomy.
  • Analysis of blood samples (preoperative and 3, 24 hours postoperative) for C-reactive protein, glucose, cortisol, tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), and interleukin-10 (IL-10).
  • Flow cytometry was used to analyze T cell (CD4, CD8), B cell (CD19), and natural killer (NK) cell (CD56, CD16) counts and NK cell function.

Main Results:

  • Minimally invasive surgery significantly decreased IL-10 levels post-surgery (P=0.016).
  • No significant changes were observed in TNF-α and IL-8 levels.
  • C-reactive protein, cortisol, and glucose levels significantly increased post-surgery (P<0.001).
  • Lymphocyte, total T cell, CD3+CD4+, CD3+CD8+, and CD16+CD56+ cell counts were significantly lower on postoperative day 1.

Conclusions:

  • Minimally invasive lobectomy induces significant changes in acute phase reactants and immune cell counts.
  • A dynamic balance between pro-inflammatory and anti-inflammatory cytokines and immune cells appears to exist post-minimally invasive lobectomy.