title: Innate immune function after breast, lung, and colorectal cancer surgery.
abstract: BACKGROUND
  The cytotoxic activity and count of natural killer (NK) cells appear to be reduced after surgery; however, it is unknown whether the magnitude of this immune suppression is similar among different types of oncological surgery. In this study, we compared the innate immune function of patients undergoing three different oncological surgeries.
  
  
  METHODS
  We compared the number and function of NK cells obtained from patients who had undergone mastectomies (n = 17), thoracotomies (n = 21), or liver resections for cancer (n = 22). Cytotoxicity assays were performed to measure the function of NK cells. We also determined the plasma concentrations of interleukins (IL) 2 and 4, interferon-γ, granzyme B, perforin, soluble major histocompatibility complex class I-related chain A, and epinephrine, both before and 24 h after surgery. Differences in immunologic parameters were compared preoperatively and postoperatively and by type of surgery. P values <0.05 were considered statistically significant.
  
  
  RESULTS
  The preoperative NK cell count differed statistically (P < 0.006) among all three types of surgeries; however, within surgery postoperative counts and changes compared with baseline did not. The postoperative function of NK cells was similar among types of surgeries, but was significantly reduced compared with preoperative levels (mastectomy P < 0.0001, thoracotomy P = 0.001, and liver resections P = 0.002). We observed a significant increase in the postoperative plasma concentrations of epinephrine, whereas the concentrations of major histocompatibility class I polypeptide-related sequence A and the IL-2 and/or IL-4 ratio remained unchanged before and after surgery.
  
  
  CONCLUSIONS
  The magnitude of innate immune suppression is similar among different oncological procedures. More studies are needed to better understand this complex phenomenon.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Ramirez
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center.
authors.forename: Di
authors.initials: D
authors.lastname: Ai
authors.affiliation: Department of Anesthesiology at Weill Cornell Medical College.
authors.forename: Maria
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center.
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vauthey
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Gottumukkala
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center.
authors.forename: Spencer
authors.initials: S
authors.lastname: Kee
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center.
authors.forename: Daliah
authors.initials: D
authors.lastname: Shon
authors.affiliation: Department of General Surgery at Mayo Clinic.
authors.forename: Mark
authors.initials: M
authors.lastname: Truty
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center.
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.affiliation: Outcomes Research Department at Mayo Clinic.
authors.forename: Anrea
authors.initials: A
authors.lastname: Kurz
authors.affiliation: Department of Biostatistics. The University of Texas MD Anderson Cancer Center.
authors.forename: Mike
authors.initials: M
authors.lastname: Hernandez
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center; Outcomes Research Consortium. Electronic address: jcata@mdanderson.org.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000276:immunology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000276:immunology / Q000601:surgery*; D016207:Cytokines / Q000502:physiology; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D007694:Killer Cells, Natural / Q000276:immunology; D008175:Lung Neoplasms / Q000276:immunology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016212:Transforming Growth Factor beta / Q000502:physiology
chemical_list: D016207:Cytokines; D016212:Transforming Growth Factor beta; D004837:Epinephrine
keywords: Cancer surgery; Natural killer cells; Surgical stress