Changes of Peripheral Lymphocyte Populations in Patients with Advanced/Recurrent Ovarian Cancer Undergoing Splenectomy During Cytoreductive Surgery

Abstract Background: To investigate the change of peripheral lymphocyte subsets after splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancers Methods: We enrolled 83 patients with advanced or recurrent ovarian cancer who underwent cytoreductive surgery. Twenty patients who also underwent splenectomy were assigned to the splenectomy cohort and the rest to the non-splenectomy cohort. Flow cytometry was used to measure the peripheral lymphocyte subsets consisting of T cells, regulatory T cells, natural killer cells, B cells, and activation antigens before and after surgery. Results: There wasn’t any difference in the number and distribution of peripheral lymphocyte subsets between the two cohorts before surgery. We observed elevated levels of T cells (CD3+, CD3+CD8+) in the splenectomy cohort compared to those in the non-splenectomy cohort after surgery, which achieved statistical significance. CD8+CD28+ T cells had a significant decreasing tendency (P=0.011) while CD3+/HLA-DR+ T cells were the opposite (P=0.001) in the splenectomy cohort. The proportion of Tregs (P=0.005) and B cells (P<0.001) including CD3-/HLA-DR+ B cells (P=0.007) increased after surgery, and the absolute number of T cells and NK cells decreased to different extents (P<0.001) in the non-splenectomy cohort. The post-operative percentage of CD8+CD28+ T cells was less than the pre-operative one (P=0.022), which was similar to the splenectomy cohort. Conclusions: The changes in peripheral lymphocyte populations were different between patients with and without splenectomy during cytoreductive surgery for ovarian cancers. T cells were increased and activated in splenectomy cohort, whereas, B cells were increased and activated in non-splenectomy.