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

Abstract

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.

Keywords:

• radical resection
• adenocarcinoma of esophagogastric junction
• cellular immunity
• perioperative

Acknowledgments

We acknowledge the medical records staff at Anyang Tumor Hospital. We are also thankful to Henan Province Science and Technology Tackling Key Project (172102310481).

Declaration of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval and consent to participate

All of the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animal subjects performed by any of the authors. All of the authors agreed to participate.

Author contributions

Shou-miao Li, Yan-xin Gong, and Zhi-zhong Zhang designed the study. Shou-miao Li, Wei Zhang, and Zhi-qiang Liu collected and analyzed the data. Shou-miao Li wrote the paper. Bao-zhong Li revised the paper.

Additional information

Funding

This study was funded by the 2017 Henan Province Science and Technology Tackling Key Project (No. 172102310481).