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：

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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

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2.	中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2019版). 中华肿瘤杂志, 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.
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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, 董跃华, 等. 单操作孔胸腔镜治疗早期周围型非小细胞肺癌. 中国胸心血管外科临床杂志, 2016, 23(12): 1132-1135.
12.	卢开进, 贾卫光, 申江峰. 单孔胸腔镜与两孔胸腔镜手术治疗肺癌的效果及创伤程度评估. 中国内镜杂志, 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.	刘让, 解明然, 柯立, 等. 微创肺段切除术与肺叶切除术治疗早期NSCLC近期结果分析. 安徽医科大学学报, 2018, 53(5): 769-773.
15.	刘懿, 赵洪林, 刘京豪, 等. 胸腔镜早期周围型肺癌根治术对患者术后炎性反应状态的影响. 中国肺癌杂志, 2014, 17(10): 730-733.
16.	张艳娇, 高禹舜. 肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究. 中国肺癌杂志, 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.	吴占波, 赵宁, 申学杰, 等. 非小细胞肺癌原发灶PET/CT SUVmax与免疫细胞亚群浸润的相关性及其临床意义. 中国肿瘤临床, 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. 中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2019版). 中华肿瘤杂志, 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, 董跃华, 等. 单操作孔胸腔镜治疗早期周围型非小细胞肺癌. 中国胸心血管外科临床杂志, 2016, 23(12): 1132-1135.
12. 卢开进, 贾卫光, 申江峰. 单孔胸腔镜与两孔胸腔镜手术治疗肺癌的效果及创伤程度评估. 中国内镜杂志, 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. 刘让, 解明然, 柯立, 等. 微创肺段切除术与肺叶切除术治疗早期NSCLC近期结果分析. 安徽医科大学学报, 2018, 53(5): 769-773.
15. 刘懿, 赵洪林, 刘京豪, 等. 胸腔镜早期周围型肺癌根治术对患者术后炎性反应状态的影响. 中国肺癌杂志, 2014, 17(10): 730-733.
16. 张艳娇, 高禹舜. 肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究. 中国肺癌杂志, 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. 吴占波, 赵宁, 申学杰, 等. 非小细胞肺癌原发灶PET/CT SUVmax与免疫细胞亚群浸润的相关性及其临床意义. 中国肿瘤临床, 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

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