title: Postoperative Regulatory T-Cells and Natural Killer Cells in Stage I Nonsmall Cell Lung Cancer Underwent Video-assisted Thoracoscopic Lobectomy or Thoracotomy.
abstract: BACKGROUND
  Regulatory T-cells (Treg) play key roles in suppressing cell-mediated immunity in cancer patients. Little is known about perioperative Treg fluctuations in nonsmall cell lung cancer (NSCLC). Video-assisted thoracoscopic (VATS) lobectomy, as a minimal invasive procedure for treating NSCLC, may have relatively less impact on the patient's immune system. This study aimed to observe perioperative dynamics of circulating Treg and natural killer (NK) cell levels in NSCLC patients who underwent major lobectomy by VATS or thoracotomy.
  
  
  METHODS
  Totally, 98 consecutive patients with stage I NSCLC were recruited and assigned into VATS or thoracotomy groups. Peripheral blood samples were taken on 1-day prior to operation, postoperative days (PODs) 1, 3, 7, 30, and 90. Circulating Treg and NK cell counts were assayed by flow cytometry, defined as CD4 + CD25 + CD127 low cells in CD4 + lymphocytes and CD56 + 16 + CD3- cells within CD45 + leukocytes respectively. With SPSS software version 21.0 (SPSS Inc., USA), differences between VATS and thoracotomy groups were determined by one-way analysis of variance (ANOVA), and differences between preoperative baseline and PODs in each group were evaluated by one-way ANOVA Dunnett t-test.
  
  
  RESULTS
  In both groups, postoperative Treg percentages were lower than preoperative status. No statistical difference was found between VATS and thoracotomy groups on PODs 1, 3, 7, and 30. On POD 90, Treg percentage in VATS group was significantly lower than in thoracotomy group (5.26 ± 2.75 vs. 6.99 ± 3.60, P = 0.012). However, a higher level of NK was found on all PODs except on POD 90 in VATS group, comparing to thoracotomy group.
  
  
  CONCLUSIONS
  Lower Treg level on POD 90 and higher NK levels on PODs 1, 3, 7, 30 in VATS group might imply better preserved cell-mediated immune function in NSCLC patients, than those in thoracotomy group.
authors.forename: Sai
authors.initials: S
authors.lastname: Zhang
authors.forename: Sai-Bo
authors.initials: SB
authors.lastname: Pan
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Lyu
authors.forename: Pin
authors.initials: P
authors.lastname: Wu
authors.forename: Guang-Ming
authors.initials: GM
authors.lastname: Qin
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.forename: Zhong-Liang
authors.initials: ZL
authors.lastname: He
authors.forename: Xue-Ming
authors.initials: XM
authors.lastname: He
authors.forename: Ming
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Thoracic Surgery, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000276:immunology* / Q000601:surgery*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*