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. 2015 Jan;3(1):79-82.
doi: 10.3892/mco.2014.442. Epub 2014 Oct 13.

CD4+ T-lymphocytes are activated by surgical stress following colorectal resection in cancer patients

Kenji Maki  1 , Shinsuke Takeno  1 , Naoya Aisu  1 , Kanefumi Yamashita  1 , Masayasu Naito  1 , Seiichiro Hoshino  1 , Yuichi Yamashita  1
Affiliations

CD4+ T-lymphocytes are activated by surgical stress following colorectal resection in cancer patients

Kenji Maki et al. Mol Clin Oncol. 2015 Jan.

Abstract

The aim of the present study was to measure adenosine triphosphate (ATP) levels in CD4+ T cells as a marker of T-cell activity following surgery for colorectal cancer using the ImmuKnow assay kit. A total of 16 consecutive patients who underwent surgical resection for colorectal cancer between August and December, 2012 were enrolled in this study, of whom 7 underwent laparoscopic resection and 9 underwent open abdominal surgery. The intracellular ATP levels in CD4+ T-lymphocytes were measured using the ImmuKnow assay kit preoperatively and on the 1st, 4th and 8th postoperative days, as were the white blood cell (WBC) count, lymphocyte count and C-reactive protein (CRP) levels. The ATP level of the CD4+ T-cells was significantly elevated on the 1st day following surgery compared to the preoperative level (P<0.01) and gradually returned to preoperative levels; the lymphocyte count was significantly decreased on the 1st postoperative day (P<0.001). In addition, the ImmuKnow assay demonstrated that only the ATP level, but not the WBC count, lymphocyte count or CRP level, exhibited a significant difference on the 1st (P=0.080) and 8th (P=0.042) postoperative days between the laparoscopic and open abdominal surgery groups. In conclusion, the ATP level of CD4+ T-lymphocytes was increased in response to surgical stress, in tandem with a decrease in the lymphocyte count. Therefore, the ImmuKnow assay kit may be clinically applicable for monitoring the immune response following surgery, as it exhibits a higher sensitivity compared to other assays.

Keywords: CD4+ T cells; ImmuKnow assay; colorectal cancer; laparoscopic surgery; surgical stress.

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Figures

Figure 1
Figure 1
Change in white blood cell count (mean ± standard deviation) following surgery. On the 1st postoperative day, the level increased to a maximum, followed by a gradual decrease over time (P<0.001).
Figure 2
Figure 2
Change in C-reactive protein level (mean ± standard deviation) following surgery. On the 1st postoperative day, the level increased to a maximum, followed by a gradual decrease over time (P<0.0001).
Figure 3
Figure 3
Change in lymphocyte count (mean ± standard deviation) following surgery. On the 1st postoperative day, the level decreased to a minimum, followed by a gradual increase over time (P<0.001).
Figure 4
Figure 4
Change in ImmuKnow assay level (mean ± standard deviation) following surgery. On the 1st postoperative day, the level increased to a maximum, followed by a gradual decrease over time (P<0.01).
Figure 5
Figure 5
Comparison of ImmuKnow assay level (mean ± standard deviation) between open and laparoscopic surgery. On the 1st postoperative day, a smaller increase was observed in the laparoscopic surgery group (P=0.080). By contrast, the level in the open surgery group was lower compared to that in the laparoscopic group on the 8th postoperative day (P=0.042).
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