title: Recovery of immunological homeostasis positively correlates both with early stages of right-colorectal cancer and laparoscopic surgery.
abstract: Differences in postoperative outcome and recovery between patients subjected to laparoscopic-assisted versus open surgery for colorectal cancer (CRC) resection have been widely documented, though not specifically for right-sided tumors. We investigated the immunological responses to the different surgical approaches, by comparing postoperative data simultaneously obtained at systemic, local and cellular levels. A total of 25 right-sided CRC patients and controls were managed, assessing -in the immediate followup- the conventional perioperative parameters and a large panel of cytokines on plasma, peritoneal fluids and lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMC) tissue cultures. A general better recovery for patients operated with laparoscopy compared to conventional procedure, as indicated by the analysis of typical pre- and post-surgical parameters, was observed. The synchronous evaluation of 12 cytokines showed that preoperative plasma levels of the proinflammatory cytokines IL-6, IL-8, IL-1β, TNFα were significantly lower in healthy donors versus CRC patients and that such differences progressively increase with tumor stage. After surgery, the IL-6 and IL-8 increases were significantly higher in open compared to laparoscopic approach only in CRC at early stages. The postsurgical whole panel of cytokine levels were significantly higher in peritoneal fluids compared to corresponding plasma, but with no significant differences depending on kind of surgery or stage of disease. Then we observed that, pre- compared to the corresponding post-surgery derived LPS-stimulated PBMC cultures, produced higher supernatant levels of the whole cytokine panel. In particular IL-6 in vitro production was significantly higher in PBMC derived from patients subjected to laparoscopic versus open intervention, but -again- only in CRC at early stages of disease. Our results thus show that laparoscopy compared to open right resection is associated with a shorter compromission of the immunological homeostasis, mainly in early stages of right-CRC patients.
authors.affiliation: Surgical and Medical Department of the Clinical Sciences, Biomedical Technologies and Translational Medicine, Faculty of Medicine and Psychology University of Rome "Sapienza", Rome, Italy ; Sant'Andrea Hospital, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Ferri
authors.forename: Simone
authors.initials: S
authors.lastname: Rossi Del Monte
authors.forename: Gerardo
authors.initials: G
authors.lastname: Salerno
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bocchetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Angeletti
authors.forename: Florence
authors.initials: F
authors.lastname: Malisan
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Torrisi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Visco
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry; D015179:Colorectal Neoplasms / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006706:Homeostasis / Q000276:immunology; D006801:Humans; D053583:Interleukin-1beta / Q000096:biosynthesis / Q000276:immunology; D015850:Interleukin-6 / Q000096:biosynthesis / Q000276:immunology; D016209:Interleukin-8 / Q000096:biosynthesis / Q000276:immunology; D010535:Laparoscopy; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061251:Primary Cell Culture; D020127:Recovery of Function / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000276:immunology
chemical_list: C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha
references.citation: Clin Dev Immunol. 2011;2011:894704
references.pmid: 22190975
references.citation: Cytokine. 1999 Feb;11(2):173-8
references.pmid: 10089141
references.citation: J Surg Oncol. 2008 Jul 1;98(1):54-9
references.pmid: 18521842
references.citation: Curr Cancer Drug Targets. 2011 May;11(4):451-64
references.pmid: 21247378
references.citation: Am J Clin Oncol. 2011 Dec;34(6):573-80
references.pmid: 21217399
references.citation: Curr Opin Urol. 2008 Mar;18(2):129-33
references.pmid: 18303531
references.citation: Ann Surg. 2007 Nov;246(5):728-33
references.pmid: 17968162
references.citation: Pathol Oncol Res. 2000;6(1):38-41
references.pmid: 10749586
references.citation: Int J Colorectal Dis. 2011 Nov;26(11):1375-85
references.pmid: 21822596
references.citation: Surg Oncol Clin N Am. 2001 Jul;10(3):655-77
references.pmid: 11685934
references.citation: Dis Colon Rectum. 2003 Feb;46(2):147-55
references.pmid: 12576886
references.citation: Cancer Treat Rev. 2008 Oct;34(6):498-504
references.pmid: 18468803
references.citation: Am J Surg. 2009 Feb;197(2):238-45
references.pmid: 18639228
references.citation: Surg Endosc. 2003 Apr;17(4):636-40
references.pmid: 12574925
references.citation: N Engl J Med. 2004 May 13;350(20):2050-9
references.pmid: 15141043
references.citation: Surg Endosc. 2003 Feb;17(2):242-6
references.pmid: 12399854
references.citation: J Biomol Screen. 2011 Oct;16(9):1018-26
references.pmid: 21807963
references.citation: Ann Surg. 2007 Dec;246(6):1010-4; discussion 1014-5
references.pmid: 18043103
references.citation: N Engl J Med. 1999 Feb 11;340(6):448-54
references.pmid: 9971870
references.citation: Chang Gung Med J. 2009 Sep-Oct;32(5):471-82
references.pmid: 19840504
references.citation: Surg Endosc. 2003 Aug;17(8):1247-50
references.pmid: 12799884
references.citation: Lancet. 2002 Jun 29;359(9325):2224-9
references.pmid: 12103285
references.citation: Surg Endosc. 2003 Jun;17(6):972-8
references.pmid: 12640542
references.citation: J Surg Res. 2010 Nov;164(1):28-37
references.pmid: 20828745
references.citation: Int J Colorectal Dis. 2012 Jun;27(6):797-802
references.pmid: 22249439
references.citation: N Engl J Med. 2005 Feb 3;352(5):476-87
references.pmid: 15689586
references.citation: Arch Surg. 2005 Jul;140(7):692-7
references.pmid: 16027336
references.citation: Ann Surg Oncol. 2000 Mar;7(2):133-8
references.pmid: 10761792
references.citation: Surg Endosc. 2003 Aug;17(8):1305-10
references.pmid: 12728374
references.citation: Colorectal Dis. 2011 Jan;13(1):e1-5
references.pmid: 20854441
references.citation: Surg Endosc. 2003 Dec;17(12):1996-2002
references.pmid: 14569448
references.citation: Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003145
references.pmid: 16034888
references.citation: Int J Colorectal Dis. 2010 May;25(5):631-8
references.pmid: 20177690
references.citation: Clin Immunol. 2002 Feb;102(2):169-78
references.pmid: 11846459
references.citation: J Surg Oncol. 2003 Aug;83(4):222-6
references.pmid: 12884234
references.citation: Ann Surg Oncol. 2008 Sep;15(9):2388-94
references.pmid: 18622647
references.citation: Dis Colon Rectum. 2003 Sep;46(9):1238-44
references.pmid: 12972969
references.citation: Dis Colon Rectum. 2001 May;44(5):638-46
references.pmid: 11357021
references.citation: Nat Rev Cancer. 2008 Nov;8(11):887-99
references.pmid: 18846100
references.citation: Am J Surg. 2011 Jan;201(1):111-21
references.pmid: 20817145
references.citation: Br J Surg. 1997 Mar;84(3):391-6
references.pmid: 9117320
references.citation: J Clin Oncol. 2011 Nov 20;29(33):4401-9
references.pmid: 21969498
references.citation: Cancer Epidemiol Biomarkers Prev. 2007 Jun;16(6):1155-9
references.pmid: 17548678
references.citation: World J Gastroenterol. 2005 Mar 21;11(11):1639-43
references.pmid: 15786541
references.citation: Surg Endosc. 2001 Jun;15(6):600-8
references.pmid: 11591950
references.citation: Ann Surg. 2008 Jul;248(1):1-7
references.pmid: 18580199
references.citation: Int J Colorectal Dis. 2010 Feb;25(2):135-40
references.pmid: 19898853
references.citation: Br J Surg. 2011 Jan;98(1):50-9
references.pmid: 20799296
references.citation: BMC Cancer. 2010 Dec 21;10:688
references.pmid: 21176147
references.citation: Eur J Cancer. 2005 Oct;41(15):2347-54
references.pmid: 16176872