Changes in peripheral lymphocyte populations in patients with advanced/recurrent ovarian cancer undergoing splenectomy during cytoreductive surgery

Wei Chen; Shuang Ye; Yutuan Wu; Xuan Pei; Libing Xiang; Bo Ping; Boer Shan; Huijuan Yang

doi:10.1186/s13048-021-00860-7

Changes in peripheral lymphocyte populations in patients with advanced/recurrent ovarian cancer undergoing splenectomy during cytoreductive surgery

J Ovarian Res. 2021 Aug 30;14(1):113. doi: 10.1186/s13048-021-00860-7.

Authors

Wei Chen^#^{1

2}, Shuang Ye^#^{1

3}, Yutuan Wu^{1

3}, Xuan Pei^{1

3}, Libing Xiang^{1

3}, Bo Ping^{1

4}, Boer Shan^{5

6}, Huijuan Yang^{7

8}

Affiliations

¹ Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
² Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, The Central Hospital of Minhang District, Shanghai, China.
³ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
⁴ Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁵ Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. shanboer@126.com.
⁶ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. shanboer@126.com.
⁷ Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. huijuanyang@hotmail.com.
⁸ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. huijuanyang@hotmail.com.

^# Contributed equally.

Abstract

Background: To investigate changes in 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 were assigned to the non-splenectomy cohort. Flow cytometry was used to measure peripheral lymphocyte subsets consisting of T cells, regulatory T cells, natural killer cells, B cells, and activation antigens before and after surgery.

Results: There was no difference in the number and distribution of peripheral lymphocyte subsets between the two cohorts before surgery. After surgery, we observed elevated levels of T cells (CD3⁺, CD3⁺CD8⁺) in the splenectomy cohort compared to those in the non-splenectomy cohort, and the difference was statistically significant. CD8⁺CD28⁺ T cells had a significant decreasing tendency (P = 0.011) while CD3⁺/HLA-DR⁺ T cells showed the opposite trend (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 percentage (P = 0.022), which was similar to the splenectomy cohort. There was no significant difference in progression-free survival or overall survival between the groups after a median follow-up time of 41 months.

Conclusions: The changes in peripheral lymphocyte populations were different between patients with and those without splenectomy during cytoreductive surgery for ovarian cancers. T cells were increased and activated in the splenectomy cohort, whereas, B cells were increased and activated in the non-splenectomy cohort.

Keywords: Cytoreductive surgery; Flow cytometry; Lymphocyte; Ovarian Neoplasms; Splenectomy; Subpopulation.

MeSH terms

Cytoreduction Surgical Procedures / methods*
Female
Humans
Lymphocyte Count / methods*
Middle Aged
Ovarian Neoplasms / blood*
Ovarian Neoplasms / surgery*
Splenectomy / methods*