Immune competent cells in lung cancer patient with lobectomy

Abstract

In a study of depression of immunity after lung lobectomy, the number and condition of immune competent cells and adrenal hormones were examined. Blood samples were drawn on the preoperative day and on the 12 hour after surgery and on the 2nd, 7th, 14th and 21st postoperative days from 15 patients followed by lobectomy and lymphnode dissection for lung cancer.
The absolute number of lymphocytes was signficantly decreased on the 12 hour after surgery and returned to the preoperative level by the 7th postoperative day. The percentages of CD4⁺, CD4⁺2H4^- (helper T cell), CD4⁺2H4+ (suppressor inducer T cell) and CD4⁺4B4⁺ (helper inducer T cell) lymphocytes were significantly decreased on the 12 hours after surgery and returned to the preoperative levels by the 2nd day. The percentages of CD8⁺, CD8⁺CD11⁺ (suppressor T cell), CD8⁺CD11^- (cytotoxic T cell) and CD8^-CD11⁺ (natural killer T cell) lymphocytes were unchanged. Lymphocyte responses to PHA and natural killer cell activity were significantly suppressed on the 12 hour after surgery and returned to preoperative levels by the 7th postoperative day, but natural killer cell activity was significantly suppressed again on the 14th and 21st post operative days. The serum cortisol and adrenalin levels were significantly elevated on the 12 hour after surgery and then returned to normal limits.
It is considered that the suppression of immunity after surgery is a reaction to maintain physiological homeostasis ; however, it is disadvantageous for cancer patients from view point of possible enhancement of metastasis and progress of the disease. Therefore, the operation should be performed because the patient derived maximum benefit from the reduction of stress during and after the operation.