title: Effect of surgery on pancreatic tumor-dependent lymphocyte asset: modulation of natural killer cell frequency and cytotoxic function.
abstract: OBJECTIVE
  Tumor burden and invasiveness establish a microenvironment that surgery could alter. This study shows a comprehensive analysis of size, dynamics, and function of peripheral lymphocyte subsets in pancreatic cancer patients before and at different times after duodenopancreatectomy.
  
  
  METHODS
  Lymphocyte frequency and natural cytotoxicity were evaluated by flow cytometry and in vitro assay on peripheral blood from initial and advanced-stage pancreatic cancer patients before (BS), at day 7 (PS7), and at day 30 (PS30) after surgery.
  
  
  RESULTS
  An increase in natural killer (NK) cells and the diminution of B-cells occurred at PS30, whereas cytotoxicity decreased at PS7. The positive correlation between NK frequency and cytotoxicity at BS and PS7 revealed an altered NK behavior. The elevation of NK cell frequency at PS30, an initial defect in CD56bright NK, and the aberrant correlation between NK frequency and cytotoxicity remained significant in advanced-stage patients, whereas the diminution of NK cytotoxicity only affected initial stage patients.
  
  
  CONCLUSIONS
  The NK cell functional ability is altered in presurgery patients; duodenopancreatectomy is associated with short-term impairment of NK function and with a long-term NK cell augmentation and reversion of the aberrant NK behavior, which may impact on immunosurveillance against residual cancer.
authors.affiliation: From the *Section of Interdisciplinary Surgery F. Durante, Department of Surgical Sciences, †Department of Molecular Medicine, ‡Istituto Italiano di Tecnologia, CLNS, and §Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Iannone
authors.forename: Alessandra
authors.initials: A
authors.lastname: Porzia
authors.forename: Giovanna
authors.initials: G
authors.lastname: Peruzzi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Birarelli
authors.forename: Bernardina
authors.initials: B
authors.lastname: Milana
authors.forename: Luca
authors.initials: L
authors.lastname: Sacco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Dinatale
authors.forename: Nadia
authors.initials: N
authors.lastname: Peparini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Prezioso
authors.forename: Simone
authors.initials: S
authors.lastname: Battella
authors.forename: Roberto
authors.initials: R
authors.lastname: Caronna
authors.forename: Stefania
authors.initials: S
authors.lastname: Morrone
authors.forename: Gabriella
authors.initials: G
authors.lastname: Palmieri
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Mainiero
authors.forename: Piero
authors.initials: P
authors.lastname: Chirletti
mesh_terms: D000368:Aged; D018920:Coculture Techniques; D003602:Cytotoxicity, Immunologic; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D020014:K562 Cells; D007694:Killer Cells, Natural / Q000276:immunology*; D007958:Leukocyte Count; D008197:Lymph Node Excision; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008297:Male; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D059016:Tumor Microenvironment