TY - JOUR
T1 - Surgical approach does not influence changes in circulating immune cell populations following lung cancer resection
AU - Deboever, Nathaniel
AU - McGrail, Daniel James
AU - Lee, Younghee
AU - Tran, Hai T.
AU - Mitchell, Kyle G.
AU - Antonoff, Mara B.
AU - Hofstetter, Wayne L.
AU - Mehran, Reza J.
AU - Rice, David C.
AU - Roth, Jack A.
AU - Swisher, Stephen G.
AU - Vaporciyan, Ara A.
AU - Walsh, Garrett L.
AU - Bernatchez, Chantale
AU - Vailati Negrao, Marcelo
AU - Zhang, Jianjun
AU - Wistuba, Ignacio I.
AU - Heymach, John V.
AU - Cascone, Tina
AU - Gibbons, Don L.
AU - Haymaker, Cara L.
AU - Sepesi, Boris
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/2
Y1 - 2022/2
N2 - Introduction: The multimodal management of operable non-small cell lung cancer (NSCLC) continues to evolve rapidly. The immune milieu allowing for immunotherapeutic benefit can be affected by multiple parameters including clinicopathologic and genetic. Surgery induced physiological changes has received attention for modulating and affecting post-operative oncotaxis and immunosuppression. Here, we sought to investigate how surgical stress influences phenotype of peripheral blood mononuclear cells (PBMCs) in patients with NSCLC who underwent lobectomy. Methods: Blood was prospectively collected from patients with Stage IA-IIIA NSCLC undergoing lung resection between 2016 and 2018. Samples were obtained pre-operatively, 24 h and 4 weeks after surgery. PBMCs were isolated and subject to high-dimensional flow cytometry, analyzing a total of 115 cell populations with a focus on myeloid cells, T cell activation, and T cell trafficking. We further evaluated how surgical approach influenced post-operative PBMC changes, whether the operation was conducted in an open fashion with thoracotomy, or with minimally invasive Video Assisted Thoracoscopic Surgery (VATS). Results: A total of 76 patients met the inclusion criteria (Open n = 55, VATS n = 21). Surgical resection coincided with a decrease in T lymphocyte populations, including total CD3+ T cells, CD8+ T cells, and T effector memory cells, as well as an increase in monocytic myeloid-derived suppressor cells (mMDSC). Post-operative changes in PBMC populations were resolved after 4 weeks. Surgical-induced changes in immune populations were equivalent in patients undergoing open thoracotomy and VATS. Discussion: Surgical stress resulted in transient reduction in T cells and T effector memory cells, and increase of mMDSC following resection in NSCLC patients. The immune profile modulation was similar regardless of surgical approach. These findings suggest that surgical approach does not seem to affect mononuclear cell lines obtained from peripheral blood. Thus, the decision regarding surgical approach should be patient centered, rather than based on post-operative treatment response optimization.
AB - Introduction: The multimodal management of operable non-small cell lung cancer (NSCLC) continues to evolve rapidly. The immune milieu allowing for immunotherapeutic benefit can be affected by multiple parameters including clinicopathologic and genetic. Surgery induced physiological changes has received attention for modulating and affecting post-operative oncotaxis and immunosuppression. Here, we sought to investigate how surgical stress influences phenotype of peripheral blood mononuclear cells (PBMCs) in patients with NSCLC who underwent lobectomy. Methods: Blood was prospectively collected from patients with Stage IA-IIIA NSCLC undergoing lung resection between 2016 and 2018. Samples were obtained pre-operatively, 24 h and 4 weeks after surgery. PBMCs were isolated and subject to high-dimensional flow cytometry, analyzing a total of 115 cell populations with a focus on myeloid cells, T cell activation, and T cell trafficking. We further evaluated how surgical approach influenced post-operative PBMC changes, whether the operation was conducted in an open fashion with thoracotomy, or with minimally invasive Video Assisted Thoracoscopic Surgery (VATS). Results: A total of 76 patients met the inclusion criteria (Open n = 55, VATS n = 21). Surgical resection coincided with a decrease in T lymphocyte populations, including total CD3+ T cells, CD8+ T cells, and T effector memory cells, as well as an increase in monocytic myeloid-derived suppressor cells (mMDSC). Post-operative changes in PBMC populations were resolved after 4 weeks. Surgical-induced changes in immune populations were equivalent in patients undergoing open thoracotomy and VATS. Discussion: Surgical stress resulted in transient reduction in T cells and T effector memory cells, and increase of mMDSC following resection in NSCLC patients. The immune profile modulation was similar regardless of surgical approach. These findings suggest that surgical approach does not seem to affect mononuclear cell lines obtained from peripheral blood. Thus, the decision regarding surgical approach should be patient centered, rather than based on post-operative treatment response optimization.
KW - Flow Cytometry
KW - Non-small cell lung cancer
KW - Peripheral blood mononuclear cells
KW - Surgical stress
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U2 - 10.1016/j.lungcan.2022.01.001
DO - 10.1016/j.lungcan.2022.01.001
M3 - Article
C2 - 35038676
AN - SCOPUS:85122709527
SN - 0169-5002
VL - 164
SP - 69
EP - 75
JO - Lung Cancer
JF - Lung Cancer
ER -