Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan 12:7:7.
doi: 10.1186/1477-7819-7-7.

Perioperative immune responses in cancer patients undergoing digestive surgeries

Masashi Ishikawa  1 , Masanori Nishioka, Norikazu Hanaki, Takayuki Miyauchi, Yutaka Kashiwagi, Hiromi Ioki, Akihiro Kagawa, Yoichi Nakamura
Affiliations

Perioperative immune responses in cancer patients undergoing digestive surgeries

Masashi Ishikawa et al. World J Surg Oncol. .

Abstract

Background: Th1/Th2 cell balance is thought to be shifted toward a Th2-type immune response not only by malignancy but also by surgical stress. The aim of this study was to estimate perioperative immune responses with respect to the Th1/Th2 balance in patients with gastrointestinal cancer.

Methods: Ninety-four patients who underwent abdominal surgeries were divided into three groups: gastric resection (n = 40), colorectal resection (n = 34) and hepatic resection (n = 20). Twelve patients undergoing laparoscopic cholecystectomy and 20 healthy subjects were served as control groups. Intracellular cytokine staining in CD4+ T lymphocytes was identified to characterize Th1/Th2 balance. Th1/Th2 balance was evaluated before operation and until postoperative days (POD) 14.

Results: The preoperative Th1/Th2 ratio was significantly lower in patients with malignancy compared with control. The Th1/Th2 ratio of patients in all groups decreased significantly postoperatively. Th1/Th2 balance on POD 2 in patients with malignancy was significantly decreased compared to patients with laparoscopic cholecystectomy, but there were no significant differences among the four groups on POD 14.

Conclusion: Patients with malignancy showed an abnormal perioperative Th1/Th2 balance suggesting predominance of a type-2 immune response. Major abdominal surgeries induce a marked shift in Th1/Th2 balance toward Th2 in the early postoperative stage.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Lymphocyte counts for patients. (Black squares – gastric resection (n = 40), black circles – colorectal resection (n = 34), black triangles – hepatic resection (n = 20), white squares – laparoscopic cholecystectomy(n = 12)). Lymphocyte count in all groups decreased significantly after surgery. The lymphocyte counts for patients with hepatic resection became significantly lower than those in the gastric and colorectal resection groups after surgery.
Figure 2
Figure 2
Changes in the Th1/2 ratio in surgical patients with respect to operative procedure. (Black squares – gastric resection (n = 40), black circles – colorectal resection (n = 34), black triangles – hepatic resection (n = 20), white squares – laparoscopic cholecystectomy(n = 12)). The Th1/2 ratio in all groups decreased significantly on POD 2 and significant differences were noted between malignancy group and LC group. However, the ratio in all groups recovered to preoperative levels on POD 14.
Figure 3
Figure 3
Perioperative changes of measurements of IFN-γ in surgical patients. (Black squares – gastric resection (n = 40), black circles – colorectal resection (n = 34), black triangles – hepatic resection (n = 20), white squares – laparoscopic cholecystectomy(n = 12)). There were no significant differences in the percentage of CD4+ IFN-γ+T cells among all groups prior to surgery. Significant decrease, however, in the postoperative percentage of CD4+ IFN-γ+T cells were not seen other than the reduction on POD 2 in the hepatic resection group.
Figure 4
Figure 4
Perioperative changes of measurements of IL-4 in surgical patients. (Black squares – gastric resection (n = 40), black circles – colorectal resection (n = 34), black triangles – hepatic resection (n = 20), white squares – laparoscopic cholecystectomy(n = 12)). There were significant differences in the percentage of CD4+ IL-4+T cells between malignancy group and LC groups prior to surgery. The postoperative percentage of CD4+ IL-4+T cells in all groups significantly increased on POD 2 compared with before operation.
Figure 5
Figure 5
Changes in Th1/Th2 ratio in surgical patients with malignancy from the viewpoint of postoperative complications. (Complication (-) n = 84, complication (+) n = 10) The patients with postoperative complications showed significantly lower Th1/2 ratios on POD 14 although there were no significant differences in the two groups before operation or on POD 2.
See this image and copyright information in PMC

References

    1. Sato M, Goto S, Kaneko R, Ito M, Sato S, Takeuchi S. Impaired production of Th1 cytokines and increased frequency of Th2 subsets in PBMC from advanced cancer patients. Anticancer Res. 1998;18:3951–3955. - PubMed
    1. Mosmann TR, Coffman RL. Th 1 and Th 2 cells: Different patterns of lymphokine secretion lead to different functional properties. Ann Rev Immunol. 1989;7:145–173. doi: 10.1146/annurev.iy.07.040189.001045. - DOI - PubMed
    1. Mosmann TR, Cherwinski H, Bond MW, Giedlin MA, Coffman RL. Two types of murine helper T cell clone. J Immunol. 1986;36:2348–2357. - PubMed
    1. Pellegrini P, Berghella AM, Del Beato T, Cicia S, Adorno D, Casciani CU. Distribution in Th1 and Th2 subsets of CD4+T cells in peripheral blood of colorectal cancer patients and involvement in cancer establishment and progression. Cancer Immunol Immunother. 1996;42:1–8. doi: 10.1007/s002620050244. - DOI - PMC - PubMed
    1. Elsasser-Beile U, Kolble N, Grussenmeyer T, Schultze-Seemann W, Wetterauer U, Gallati H, Schulte Mönting J, von Kleist S. Th1 and Th2 cytokine response patterns in leukocyte cultures of patients with urinary bladder, renal cell and prostate carcinomas. Tumor Biol. 1998;9:470–476. doi: 10.1159/000030039. - DOI - PubMed

MeSH terms

LinkOut - more resources