Perioperative immune responses in cancer patients undergoing digestive surgeries
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.
Conclusions: 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.
Author: Masashi Ishikawa, Masanori Nishioka, Norikazu Hanaki, Takayuki Miyauchi, Yutaka Kashiwagi, Hiromi Ioki, Hiroaki Kagawa and Yoichi Nakamura
Credits/Source: World Journal of Surgical Oncology 2009, 7:7
Published on: 2009-01-12
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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