Effect of segmentectomy versus lobectomy under single utility port video-assisted thoracic surgery on inflammatory factors and immune cells in peripheral blood of non-small cell lung cancer patients: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 GAO Yongshan ¹ , ZHANG Zhijie ² , FU Wei ¹ , ZHANG Zhenming ¹ , DONG Yuehua ¹ , WANG Dawei ¹ , YANG Yanjun ¹ , JIANG Weihua ¹

1. Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, P. R. China;
2. Department of Radiology, The 81st Army Hospital of the Chinese People's Liberation Army, Zhangjiakou, 075000, Hebei, P. R. China;

Corresponding?author：

GAO Yongshan, Email: gaoyongshan3333@163.com

Keywords：

Inflammatory factors; immune cells; non-small cell lung cancer; single utility port; video-assisted thoracic surgery (VATS)

DOI：

10.7507/1007-4848.202011063

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical effects of segmentectomy versus lobectomy under single utility port video-assisted thoracic surgery on inflammatory factors and immune cells in peripheral blood of non-small cell lung cancer patients, and to analyze the effect of changes of postoperative inflammatory factors and immune cells on the prognosis of the patients.Methods The clinical data of 256 patients who underwent segmentectomy or lobectomy under single utility port video-assisted thoracic surgery for non-small cell lung cancer in the First Affiliated Hospital of Hebei North University from January 2016 to October 2020 were retrospectively collected. According to the operation method, they were divided into a segmentectomy group (126 patients with 79 males and 47 females at an age of 63.4±6.2 years) and a lobectomy group (130 patients with 91 males and 39 females at an age of 62.9±5.6 years). The change of inflammatory factors (C reactive protein, interleukin-6, interleukin-8, tumor necrosis factor-α) and immune cells (CD4⁺T cells, CD8⁺T cells and natural killer cells) were recorded and analyzed before operation (T₀) and 1 day (T₁), 3 days (T₂), 7 days (T₃), 1 month (T₄) after the operation between the two groups. According to postoperative recurrence situations, they were divided into a recurrence group and a non-recurrence group, multivariate logistic regression analysis was used to analyze the relationship between the change of postoperative inflammatory factors, immune cells, and the prognosis of patients with non-small cell lung cancer.Results (1) There was no statistical difference in sex ratio, underlying diseases, body mass index, levels of preoperative inflammatory factors or immune cells between the two groups (all P>0.05). (2) The changes of postoperative inflammatory factors in the segmentectomy group were significantly less than those in the lobectomy group at T₁-T₃ (all P<0.05), and the changes of postoperative immune cells in the segmentectomy group were significantly less than those in the lobectomy group at T₁-T₄ (all P<0.05). (3) The changes of postoperative inflammatory factors and immune cells on postoperative day 3 in the recurrence group were significantly more than those in the non-recurrence group (all P<0.05). (4) Multivariate logistic regression analysis showed that the changes of postoperative inflammatory factors and immune cells on postoperative day 3 may be the risk factors for postoperative recurrence and metastasis in patients with non-small cell lung cancer (all P<0.05).Conclusion Single utility port video-assisted thoracic surgery segmentectomy for the treatment of non-small cell lung cancer can reduce the inflammatory response and protect body's immune function, and the change of postoperative inflammatory factors and immune cells in postoperative day 3 may be the risk factors for postoperative recurrence and metastasis in patients with non-small cell lung cancer.

Citation： GAO Yongshan, ZHANG Zhijie, FU Wei, ZHANG Zhenming, DONG Yuehua, WANG Dawei, YANG Yanjun, JIANG Weihua. Effect of segmentectomy versus lobectomy under single utility port video-assisted thoracic surgery on inflammatory factors and immune cells in peripheral blood of non-small cell lung cancer patients: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(10): 1330-1336. doi: 10.7507/1007-4848.202011063 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2019版). 中華腫瘤雜志, 2020, 42(4): 257-287.
3.	Khakwani A, Harden S, Beckett P, et al. Post-treatment survival difference between lobectomy and stereotactic ablative radiotherapy in stage Ⅰ non-small cell lung cancer in England. Thorax, 2020, 75(3): 237-243.
4.	Bedetti B, Bertolaccini L, Rocco R, et al. Segmentectomy versus lobectomy for stage Ⅰ non-small cell lung cancer: A systematic review and meta-analysis. J Thorac Dis, 2017, 9(6): 1615-1623.
5.	Cao J, Yuan P, Wang Y, et al. Survival rates after lobectomy, segmentectomy, and wedge resection for non-small cell lung cancer. Ann Thorac Surg, 2018, 105(5): 1483-1491.
6.	Moon MH, Moon YK, Moon SW. Segmentectomy versus lobectomy in early non-small cell lung cancer of 2 cm or less in size: A population-based study. Respirology, 2018, 23(7): 695-703.
7.	Shao C, Zheng C, Yan W, et al. Evaluation of efficacy and safety of minimally invasive segmentectomy in the treatment of lung cancer. Oncol Lett, 2018, 15(6): 9516-9522.
8.	Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis, 2018, 10(4): 2331-2337.
9.	Sagawa M, Oizumi H, Suzuki H, et al. A prospective 5-year follow-up study after limited resection for lung cancer with ground-glass opacity. Eur J Cardiothorac Surg, 2018, 53(4): 849-856.
10.	Jiao P, Sun Y, Tian W, et al. Simple method for distinguishing the intersegmental plane in thoracoscopic lung segmentectomy. Thorac Cancer, 2020, 11(6): 1758-1760.
11.	高永山, 薛占霞, 董躍華, 等. 單操作孔胸腔鏡治療早期周圍型非小細胞肺癌. 中國胸心血管外科臨床雜志, 2016, 23(12): 1132-1135.
12.	盧開進, 賈衛光, 申江峰. 單孔胸腔鏡與兩孔胸腔鏡手術治療肺癌的效果及創傷程度評估. 中國內鏡雜志, 2018, 24(1): 60-65.
13.	Ng CS, Lau KK. Surgical trauma and immune functional changes following major lung resection. Indian J Surg, 2015, 77(1): 49-54.
14.	劉讓, 解明然, 柯立, 等. 微創肺段切除術與肺葉切除術治療早期NSCLC近期結果分析. 安徽醫科大學學報, 2018, 53(5): 769-773.
15.	劉懿, 趙洪林, 劉京豪, 等. 胸腔鏡早期周圍型肺癌根治術對患者術后炎性反應狀態的影響. 中國肺癌雜志, 2014, 17(10): 730-733.
16.	張艷嬌, 高禹舜. 肺癌胸腔鏡肺葉切除、胸腔鏡肺段切除與開胸肺葉切除術后對肺功能影響的研究. 中國肺癌雜志, 2016, 19(10): 700-704.
17.	Kinoshita T, Goto T. Molecular mechanisms of pulmonary fibrogenesis and its progression to lung cancer: A review. Int J Mol Sci, 2019, 20(6): 1461.
18.	Nojiri T, Hamasaki T, Inoue M, et al. Long-term impact of postoperative complications on cancer recurrence following lung cancer surgery. Ann Surg Oncol, 2017, 24(4): 1135-1142.
19.	Li YD, Lamano JB, Lamano JB, et al. Tumor-induced peripheral immunosuppression promotes brain metastasis in patients with non-small cell lung cancer. Cancer Immunol Immunother, 2019, 68(9): 1501-1513.
20.	Ivanova OK, Sharapova TN, Romanova EA, et al. CD3⁺ CD8⁺ NKG2D⁺ T lymphocytes induce apoptosis and necroptosis in hla-negative cells via fasl-fas interaction. J Cell Biochem, 2017, 118(10): 3359-3366.
21.	Antonia SJ, Villegas A, Daniel D, et al. Durvalumab after chemoradiotherapy in stage Ⅱ non-small-cell lung cancer. N Engl J Med, 2017, 377(20): 1919-1929.
22.	Forde PM, Chaft JE, Smith KN, et al. Neoadjuvant PD-1 blockade in resectable lung cancer. N Engl J Med, 2018, 378(21): 1976-1986.
23.	吳占波, 趙寧, 申學杰, 等. 非小細胞肺癌原發灶PET/CT SUVmax與免疫細胞亞群浸潤的相關性及其臨床意義. 中國腫瘤臨床, 2017, 44(3): 112-117.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. 中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2019版). 中華腫瘤雜志, 2020, 42(4): 257-287.
3. Khakwani A, Harden S, Beckett P, et al. Post-treatment survival difference between lobectomy and stereotactic ablative radiotherapy in stage Ⅰ non-small cell lung cancer in England. Thorax, 2020, 75(3): 237-243.
4. Bedetti B, Bertolaccini L, Rocco R, et al. Segmentectomy versus lobectomy for stage Ⅰ non-small cell lung cancer: A systematic review and meta-analysis. J Thorac Dis, 2017, 9(6): 1615-1623.
5. Cao J, Yuan P, Wang Y, et al. Survival rates after lobectomy, segmentectomy, and wedge resection for non-small cell lung cancer. Ann Thorac Surg, 2018, 105(5): 1483-1491.
6. Moon MH, Moon YK, Moon SW. Segmentectomy versus lobectomy in early non-small cell lung cancer of 2 cm or less in size: A population-based study. Respirology, 2018, 23(7): 695-703.
7. Shao C, Zheng C, Yan W, et al. Evaluation of efficacy and safety of minimally invasive segmentectomy in the treatment of lung cancer. Oncol Lett, 2018, 15(6): 9516-9522.
8. Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis, 2018, 10(4): 2331-2337.
9. Sagawa M, Oizumi H, Suzuki H, et al. A prospective 5-year follow-up study after limited resection for lung cancer with ground-glass opacity. Eur J Cardiothorac Surg, 2018, 53(4): 849-856.
10. Jiao P, Sun Y, Tian W, et al. Simple method for distinguishing the intersegmental plane in thoracoscopic lung segmentectomy. Thorac Cancer, 2020, 11(6): 1758-1760.
11. 高永山, 薛占霞, 董躍華, 等. 單操作孔胸腔鏡治療早期周圍型非小細胞肺癌. 中國胸心血管外科臨床雜志, 2016, 23(12): 1132-1135.
12. 盧開進, 賈衛光, 申江峰. 單孔胸腔鏡與兩孔胸腔鏡手術治療肺癌的效果及創傷程度評估. 中國內鏡雜志, 2018, 24(1): 60-65.
13. Ng CS, Lau KK. Surgical trauma and immune functional changes following major lung resection. Indian J Surg, 2015, 77(1): 49-54.
14. 劉讓, 解明然, 柯立, 等. 微創肺段切除術與肺葉切除術治療早期NSCLC近期結果分析. 安徽醫科大學學報, 2018, 53(5): 769-773.
15. 劉懿, 趙洪林, 劉京豪, 等. 胸腔鏡早期周圍型肺癌根治術對患者術后炎性反應狀態的影響. 中國肺癌雜志, 2014, 17(10): 730-733.
16. 張艷嬌, 高禹舜. 肺癌胸腔鏡肺葉切除、胸腔鏡肺段切除與開胸肺葉切除術后對肺功能影響的研究. 中國肺癌雜志, 2016, 19(10): 700-704.
17. Kinoshita T, Goto T. Molecular mechanisms of pulmonary fibrogenesis and its progression to lung cancer: A review. Int J Mol Sci, 2019, 20(6): 1461.
18. Nojiri T, Hamasaki T, Inoue M, et al. Long-term impact of postoperative complications on cancer recurrence following lung cancer surgery. Ann Surg Oncol, 2017, 24(4): 1135-1142.
19. Li YD, Lamano JB, Lamano JB, et al. Tumor-induced peripheral immunosuppression promotes brain metastasis in patients with non-small cell lung cancer. Cancer Immunol Immunother, 2019, 68(9): 1501-1513.
20. Ivanova OK, Sharapova TN, Romanova EA, et al. CD3⁺ CD8⁺ NKG2D⁺ T lymphocytes induce apoptosis and necroptosis in hla-negative cells via fasl-fas interaction. J Cell Biochem, 2017, 118(10): 3359-3366.
21. Antonia SJ, Villegas A, Daniel D, et al. Durvalumab after chemoradiotherapy in stage Ⅱ non-small-cell lung cancer. N Engl J Med, 2017, 377(20): 1919-1929.
22. Forde PM, Chaft JE, Smith KN, et al. Neoadjuvant PD-1 blockade in resectable lung cancer. N Engl J Med, 2018, 378(21): 1976-1986.
23. 吳占波, 趙寧, 申學杰, 等. 非小細胞肺癌原發灶PET/CT SUVmax與免疫細胞亞群浸潤的相關性及其臨床意義. 中國腫瘤臨床, 2017, 44(3): 112-117.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of segmentectomy versus lobectomy under single utility port video-assisted thoracic surgery on inflammatory factors and immune cells in peripheral blood of non-small cell lung cancer patients: A retrospective cohort study

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content