T lymphocyte subsets and Th1/Th2 balance after laparoscopy-assisted distal gastrectomy

Surg Endosc. 2003 Sep;17(9):1440-4. doi: 10.1007/s00464-002-9149-3. Epub 2003 Jun 25.

Abstract

Background: Laparoscopic surgery provides for a less invasive procedure than open surgery in patients with gastric cancer, but the immune responses after laparoscopic surgery for early gastric cancer remain unknown.

Methods: Peripheral blood mononuclear cells from 20 patients with early gastric cancer who underwent laparoscopy-assisted distal gastrectomy (LADG) or open distal gastrectomy (ODG) were obtained; the cell surface molecules and intracellular cytokines (IFN-gamma and IL-4) were measured by flow cytometry.

Results: The populations of T lymphocytes after LADG, including CD3-, 4-, 8-, 57-, and HLA-DR-positive lymphocytes, showed patterns similar to those after ODG. The production of IFN-gamma as Th1 cell function decreased significantly on the third postoperative day after ODG but increased after LADG. The production of IL-4, representing Th2 cell function, increased postoperatively after ODG but not after LADG.

Conclusions: When compared with ODG, LADG contributes to the preservation of postsurgical Th1 cell-mediated immune function.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Carcinoma / immunology
  • Carcinoma / surgery*
  • Comorbidity
  • Female
  • Gastrectomy / methods*
  • Humans
  • Immunity, Cellular
  • Immunophenotyping
  • Interferon-gamma / biosynthesis
  • Interleukin-4 / biosynthesis
  • Laparoscopy / methods*
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Postoperative Period
  • Stomach Neoplasms / immunology
  • Stomach Neoplasms / surgery*
  • T-Lymphocyte Subsets / immunology*
  • Th1 Cells / immunology
  • Th2 Cells / immunology

Substances

  • Interleukin-4
  • Interferon-gamma