Effect of Radical Surgery for Advanced Adenocarcinoma of Esophagogastric Junction on Perioperative Cellular Cell Immunity

• Published in: Journal of investigative surgery 2021-02, Vol.34 (2), p.134-141
• Main Authors: Li, Shou-miao, Gong, Yan-xin, Zhang, Zhi-zhong, Zhang, Wei, Liu, Zhi-qiang, Li, Bao-zhong
• Format: Article
• Language: English
• Subjects: adenocarcinoma of esophagogastric junction; cellular immunity; perioperative; radical resection
• ISSN: 0894-1939; 1521-0553
• DOI: 10.1080/08941939.2019.1606963

Background: To investigate the perioperative peripheral blood levels of CD4 + CD25 + regulatory T cells, programed cell death 1 (PD-1), and lymphocyte activation gene 3 (LAG-3) in patients with advanced Siewert type II adenocarcinoma of esophagogastric junction (AEG). Methods: Patients (n = 102) with advanced Siewert type II AEG underwent open total gastrectomy/proximal gastrectomy with a transhiatal resection of the distal esophagus and lymphadenectomy of the lower mediastinum and the abdominal D2 compartment. Flow cytometry was used to detect CD4 + CD25 + T cells, PD-1 and LAG-3 expression on both CD4 + and CD8 + T cells in the peripheral blood of the Siewert type II AEG patients prior to surgery and on postoperative day (POD) 1, 3, 7, and 9. Results: The proportion of CD4 + CD25 + T cells rapidly decreased on POD 1, then gradually increased and peaked at POD 7. The proportion of CD4 + PD-1 + T cells significantly increased after surgery, reaching a maximum on POD 1, and remained significantly elevated on POD 3 compared to the preoperative day. The proportion of CD8 + PD-1 + and CD4 + LAG-3 + T cells gradually increased after surgery and reached a peak at POD 7. The change in proportion of CD8 + LAG-3 + T cells in the peripheral venous blood lymphocytes after surgery was not statistically significant. Conclusion: The change in the CD4 + PD-1 + T lymphocyte ratio may likely reflect the cellular immunity status of the perioperative period.