The Impact On Perioperative Immune Function Of Single-Portal Video-Assisted Thorascopic Lobectomy For Patients With Lung Cancer

Objective:To test the expression of activity of T lymphocyte subset in peripheral venous blood of patients,who accepted single-portal video-assisted thorascopic lobectomy or traditional three-portal video-assisted thorascopic lobectomy,with early-stage non-small lung cancer during the perioperative period.To analyze changes of immunologic function indexes of CD3+,CD4+,CD8+ and CD4+/CD8+ in patients who underwent single-portal video-assisted thorascopic lobectomy and patients who underwent three-portal video-assisted thorascopic lobectomy.To provide suggestion about clinical choices of surgical treatment for patients suffered from early-stage non-small lung cancer.Methods:We select 31 patients who underwent single-portal video-assisted thorascopic lobectomy(SP group)and 49 patients who underwent three-portal video-assisted thorascopic lobectomy(TP group)from the department of thoracic surgery of First Affiliated Hospital of Kunming Medical University form September 2015 to January 2018.Meanwhile we choose 21 healthy people who took health examination in Health Examination Center of First Affiliated Hospital of Kunming Medical University as control group.There are no statistical differences between the two groups above,about gender,age,locations of cancer,pathological types,TNM stages,activity of T lymphocyte subset before surgery and operation time(P>0.05).We test indexes of activity of T lymphocyte subset during postoperative 1st day,3rd day and 7th day,then we analyze the values in and between the groups.Results:All values of CD3+,CD4+ and CD4+/CD8+ from SP group and TP group are lower than which from the control group,meanwhile indexes of CD8+ are higher.Values,that activity of T lymphocyte subset like CD3+ and CD4+,from SP group and TP groiup during postoperative period are lower than which we tested before surgery(P<0.05).On the 1st day after surgery,the values of CD3+,CD4+and CD4+/CD8+ we test from both groups are significantly lower than which we tested before surgery.Decreasing of CD3+ and CD4+ from both surgical groups are same roughly.There are no significant changes of indexes of CD8+ between the 1st day and preoperative time.On the 3rd day after surgery,values of CD4+and CD4+/CD8+ from both surgical groups are gradually recovering,but lower than which on preoperative time significantly(P<0.05).Values of CD8+ change slightly.On the 7th day after surgery,comparing with the 1st day,values of the activity expression of CD3+ and CD4+ from surgical groups are recovering significant,but lower than which on preoperative time.Values from the SP group rise more distinctly(P<0.05).Values of CD8+ are lower than preoperative time(P<0.05).There are no postoperative complications,recurrence of tumor or death in all patients we investigate.Conclusions:All patients suffered from early-staged non-small lung cancer are in low status of immune function.Surgical treatment will further weaken it.Comparing the two surgical groups we investigate,single-portal video-assisted thorascopic lobectomy has less effect on immune function of patients suffered from early-staged non-small lung cancer...