title: The difference of the impacts of surgical approaches on cellular immunity in patients with uterine malignancies: a comparative study of laparoscopy and laparotomy surgery.
abstract: OBJECTIVE
  To explore the impact of laparoscopy and laparotomy surgery on cellular immunity in patients with malignant uterine tumors.
  
  
  METHODS
  Thirty-eight women with uterine malignancies were enrolled in a prospective nonrandomized cohort study. Either laparoscopy or laparotomy was performed according to the patients' choice. The frequency of CD3+, CD4+, CD8+ T cells and natural killer cells derived from peripheral venous blood was evaluated by flow cytometry.
  
  
  RESULTS
  (1) Postoperatively, there was a decrease in the number of lymphocyte counts, especially after laparotomy, on the first postoperative day (p < 0.01). (2) Compared with preoperative levels, the frequencies of CD3+ and CD4+ cells and the CD4+/CD8+ ratio were declined both in the laparoscopy and laparotomy groups on postoperative day 1 (p < 0.01). (3) The frequencies of CD3+ and CD4+ cells and the ratio of CD4+ to CD8+ cells were less depressed in the laparoscopy group on the first postoperative day (p < 0.05). (4) The frequency of natural killer cells increased, both in the laparoscopy and laparotomy groups on the first postoperative day (p < 0.01), but there were no significant differences between the two groups (p > 0.05).
  
  
  CONCLUSIONS
  Cellular immunity was temporally depressed in patients with uterine malignancy after surgical treatment, but laparoscopic surgery depressed the immunity less than laparotomy.
authors.affiliation: Department of Obstetrics and Gynecology, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: Nawei
authors.initials: N
authors.lastname: Zhang
authors.forename: Haiyan
authors.initials: H
authors.lastname: Liu
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Zhang
authors.forename: Shuzhen
authors.initials: S
authors.lastname: Wang
authors.forename: Shuli
authors.initials: S
authors.lastname: Guo
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000601:surgery*; D000328:Adult; D000368:Aged; D017252:CD3 Complex / Q000097:blood / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000601:surgery*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007694:Killer Cells, Natural / Q000276:immunology; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D018655:Lymphocyte Count; D008875:Middle Aged; D018203:Sarcoma, Endometrial Stromal / Q000276:immunology / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000601:surgery*
chemical_list: D017252:CD3 Complex