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Evaluation of immune responses of gastric cancer patients treated by laparoscopic and open gastrectomy

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Abstract

Laparoscopic surgery has been shown to offer more advantages than open surgery for the treatment of gastric cancer. However, the perioperative immune responses after laparoscopic surgery remain largely unexplored. Here, we analyzed the immunity of gastric cancer patients treated by laparoscopy-assisted gastrectomy (LAG) or open gastrectomy (OG) with D2 dissection. Seventy patients were randomized into LAG and OG groups. The operative details and postoperative outcomes of the two groups were compared. The immune factors were measured preoperatively as well as on the first, third, and seventh postoperative days (POD). Our results indicate that there was no significant difference between two groups in clinical characteristics. The profiles of white blood cells, neutrophils, lymphocytes, as well as the lymphocyte subpopulations, including T lymphocytes, B lymphocytes, CD4+ T cells, and CD8+ T cells were similar in the LAG and the OG groups. Only the natural killer cell counts were significantly higher in LAG-treated patients than in OG-treated ones on POD7. Moreover, no statistical differences were found between the two groups with respect to the levels of perioperative cytokines, including IFN-γ, IL-4, IL-6, and TNF-α. However, compared with the OG group, most of the immune factors in the LAG group had trends to return to preoperative levels on POD7. Our study demonstrates that the immune function of LAG-treated patients showed patterns similar to that of OG-treated patients, although larger prospective multicenter trials are needed to further evaluate the immunological status of LAG.

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References

  1. Goh P, Tekant Y, Isaac J, Kum CK, Ngoi SS. The technique of laparoscopic Billroth II gastrectomy. Surg Laparosc Endosc. 1992;2:258–60.

    CAS  PubMed  Google Scholar 

  2. Cui M, Li Z, Xing J, Yao Z, Liu M, Chen L, Zhang C, Yang H, Zhang N, Tan F, Jiang B, Di J, Wang Z, Ji J, Su X. A prospective randomized clinical trial comparing D2 dissection in laparoscopic and open gastrectomy for gastric cancer. Med Oncol. 2015;32:680.

    PubMed  Google Scholar 

  3. Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, Cho GS, Kim CY, Yang HK, Park DJ, Song KY, Lee SI, Ryu SY, Lee JH, Lee HJ, Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2015. doi:10.1097/SLA.0000000000001346.

    Google Scholar 

  4. Quan Y, Huang A, Ye M, Xu M, Zhuang B, Zhang P, Yu B, Min Z. Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis. Gastric Cancer. 2015. doi:10.1007/s10120-015-0516-x.

    PubMed  Google Scholar 

  5. Kimura A, Ogata K, Kogure N, Yanoma T, Suzuki M, Toyomasu Y, Ohno T, Mochiki E, Kuwano H. Outcome of laparoscopic gastrectomy with D1 plus lymph node dissection in gastric cancer patients postoperatively diagnosed with locally advanced disease or lymph node metastasis. Surg Endosc. 2015. doi:10.1007/s00464-015-4462-9.

    Google Scholar 

  6. Chen XZ, Wen L, Rui YY, Liu CX, Zhao QC, Zhou ZG, Hu JK. Long-term survival outcomes of laparoscopic versus open gastrectomy for gastric cancer: a systematic review and meta-analysis. Medicine (Baltimore). 2015;94:e454.

    Article  Google Scholar 

  7. Okholm C, Goetze JP, Svendsen LB, Achiam MP. Inflammatory response in laparoscopic vs. open surgery for gastric cancer. Scand J Gastroenterol. 2014;49:1027–34.

    Article  CAS  PubMed  Google Scholar 

  8. Karanika S, Karantanos T, Theodoropoulos GE. Immune response after laparoscopic colectomy for cancer: a review. Gastroenterol Rep (Oxf). 2013;1:85–94.

    Article  Google Scholar 

  9. Wu MH, Wang MY, Yang CY, Lee PH, Lin MT. Inflammatory response attenuation in patients undergoing gasless laparoscopic gastrectomy. Hepatogastroenterology. 2013;60:439–42.

    CAS  PubMed  Google Scholar 

  10. Cui M, Xing JD, Yang W, Ma YY, Yao ZD, Zhang N, Su XQ. D2 dissection in laparoscopic and open gastrectomy for gastric cancer. World J Gastroenterol. 2012;18:833–9.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  12. Adachi Y, Shiraishi N, Shiromizu A, Bandoh T, Aramaki M, Kitano S. Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg. 2000;135:806–10.

    Article  CAS  PubMed  Google Scholar 

  13. Shu ZB, Cao HP, Li YC, Sun LB. Influences of laparoscopic-assisted gastrectomy and open gastrectomy on serum interleukin-6 levels in patients with gastric cancer among Asian populations: a systematic review. BMC Gastroenterol. 2015;15:52.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Ishikawa M, Nishioka M, Hanaki N, Miyauchi T, Kashiwagi Y, Ioki H, Kagawa A, Nakamura Y. Perioperative immune responses in cancer patients undergoing digestive surgeries. World J Surg Oncol. 2009;7:7.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Jung IK, Kim MC, Kim KH, Kwak JY, Jung GJ, Kim HH. Cellular and peritoneal immune response after radical laparoscopy-assisted and open gastrectomy for gastric cancer. J Surg Oncol. 2008;98:54–9.

    Article  CAS  PubMed  Google Scholar 

  16. Fujii K, Sonoda K, Izumi K, Shiraishi N, Adachi Y, Kitano S. T lymphocyte subsets and Th1/Th2 balance after laparoscopy-assisted distal gastrectomy. Surg Endosc. 2003;17:1440–4.

    Article  CAS  PubMed  Google Scholar 

  17. Choi YB. Laparoscopic gatrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer. Surg Endosc. 2002;16:1620–6.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded by the National Natural Science Foundation of China (Nos. 81272766, 81450028), the National High Technology Research and Development Program of China (863 Program, No. 2014AA020603), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. XM201309), Peking University (PKU) 985 Special Funding for Collaborative Research with PKU Hospitals (To Xiangqian Su and Fan Bai), Seeding Grant for Medicine and Life Sciences of Peking University (2014-MB-04), Science Foundation of Peking University Cancer Hospital & Institute (No. 2014-14).

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Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China

    Ming Cui, Chaofan Gong, Beihai Jiang, Zhendan Yao, Lei Chen, Jiabo Di, Jiadi Xing, Hong Yang, Chenghai Zhang, Nan Zhang, Maoxing Liu, Fei Tan, Zaozao Wang & Xiangqian Su

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  1. Ming Cui
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  2. Chaofan Gong
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  3. Beihai Jiang
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  4. Zhendan Yao
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  5. Lei Chen
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  6. Jiabo Di
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  7. Jiadi Xing
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  8. Hong Yang
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  9. Chenghai Zhang
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  10. Nan Zhang
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  11. Maoxing Liu
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  12. Fei Tan
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  13. Zaozao Wang
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  14. Xiangqian Su
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Correspondence to Xiangqian Su.

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

The studies have been approved by the Research Ethics Committee of Peking University Cancer Hospital & Institute, Beijing, China (Approved No. 2012071710) and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Research Ethics Committee of Peking University Cancer Hospital & Institute, Beijing, China (No. 2012071710) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Cui, M., Gong, C., Jiang, B. et al. Evaluation of immune responses of gastric cancer patients treated by laparoscopic and open gastrectomy. Med Oncol 32, 253 (2015). https://doi.org/10.1007/s12032-015-0699-3

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  • DOI: https://doi.org/10.1007/s12032-015-0699-3

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