Dynamics of peripheral lymphocyte subsets in gastric cancer patients underwent laparoscopic D2 gastrectomy

AbstractBackground: Postoperative complications and poor short-term outcomes were common among patients with locally advanced gastric cancer. This study aimed to explore the postoperative peripheral lymphocyte subsets dynamics and potential factors associated with decreased postoperative lymphocyte subset counts in patients with gastric cancer after laparoscopic D2 gastrectomy. Methods: The clinicopathological characteristics of the included patients were retrospectively collected. We recorded the data of perioperative peripheral lymphocyte subset counts. We investigate the impact factors associated with decreased postoperative lymphocytes subset counts in univariate and multivariate analysis. Results: In total, 169 patients were included in the final analysis. On postoperative day 7, the median percentage of T cell, B cell, NK cell and memory T cell decrease was -26.1%, -30.8%, -44.8% and -2.3% respectively. The median percentage of naive T cell and regulatory T cell change was 6.0% and 15.0% respectively. Postoperative thymosin alpha 1 (Tα1) treatment was a protective factor for postoperative T cell and B cell decrease (p<0.05). In the multivariate analysis, the independent predictive factors for postoperative T cell decrease were Interleukin-1β level (HR=3.66, p=0.01), operation time (HR=2.98, p=0.02) and Tα1 therapy (HR=0.15, p<0.01) Conclusions: Our findings revealed the dynamics and impact factors for postoperative lymphocyte subsets change in patients with gastric cancer after laparoscopic D2 gastrectomy. We also found that Tα1 treatment was a protective factor for postoperative T and B lymphocyte decrease.