Sub-optimal primary surgery leads to unfavorable immunological changes in ovarian cancer patients
| Autor: | Krzysztof Szyłło, Małgorzata Banasik, Magdalena Klink, Katarzyna Bednarska, Kinga Zimna, Ewa Głowacka, Przemysław Lewkowicz, Marek Nowak |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Immunology Carcinoma Ovarian Epithelial T-Lymphocytes Regulatory Transforming Growth Factor beta1 03 medical and health sciences 0302 clinical medicine Postoperative Complications Tumor Microenvironment Immunology and Allergy Medicine Humans IL-2 receptor Neoplasms Glandular and Epithelial Stage (cooking) Immunosuppression Therapy Ovarian Neoplasms Chemotherapy business.industry Interleukin-6 Standard treatment Hazard ratio Interleukin-8 Ovary Immunosuppression Epithelial Cells Hematology Cytoreduction Surgical Procedures Middle Aged medicine.disease Debulking Survival Analysis Surgery Interleukin-10 030104 developmental biology Treatment Outcome 030220 oncology & carcinogenesis Female business Ovarian cancer |
| Zdroj: | Immunobiology. 223(1) |
| ISSN: | 1878-3279 |
| Popis: | Primary cytoreduction, followed by chemotherapy, is a standard treatment of patients with epithelial ovarian cancer (EOC). However, the effectiveness of this treatment depend on various elements e.g. type of operation. It is accepted that optimal surgery correlates with longer survival of patients. The other element, an efficiency of immune system after surgical intervention although important is less elucidated. The aim of this study was to establish the impact of optimal and sub-optimal operation on immunological status of EOC patients regarding also their overall survival (OS). On the day of primary cytoreduction and 7 days after, the selected serum immunological parameters were determined in 49 patients with confirmed EOC. We found that, the level of immunosuppressive (interleukin 10; transforming growth factor-β − TGF-β1) and pro-inflammatory (interleukin-6 and 8) cytokines was significantly higher in the group of patients with advanced stage of disease, compared to early stage. However, the number of circulating CD3 + , CD4 + or CD8 + cells, CD19 + and NK cells was similar in both group of EOC patients. The overall survival of patients who underwent optimal cytoreduction was significantly higher than that in whom only sub-optimal surgery was performed. Sub-optimal cytoreduction only partially weakened the serum level of TGF-β1 and IL-8 and what is more enhanced the number of circulating CD4 + CD25 +high cells in patients with advanced stage of disease. Sub-optimal surgery and high post-operative level of TGF-β1 increased the hazard ratio for patients. Besides, we noticed that the high pre-operative concentration of TGF-β1 could distinguish all EOC patients (independently of FIGO classification) for whom optimal or sub-optimal surgery would be applied. Sub-optimal debulking resulted in higher immunosuppression and lower OS of EOC patients. |
| Databáze: | OpenAIRE |
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