The Clinical Study Of The Changes Of Perioperative T Cell Receptor Imm Une Diversity Of Colorectal Cancer Patients

Objective: By observing and analyzing the changes of perioperative T cell receptor(TCR)immune diversity of patients with colorectal cancer(CRC)who experienced different anesthesia,for whom we expected to search for an ideal anesthesia method.Methods: In this study,we observed the discrepancy of TCR immune diversity between 10 healthy individuals and 10 CRC patients before operation,and also observed the changes of perioperative TCR immune diversity of 10 CRC patients experiencing different anesthesia(6 cases in general anesthesia group,and 4 cases in epidural block combined general anesthesia group)using high-throughput sequencing technology.We extracted T lymphocytes from fasting peripheral vein blood and built the TCR DNA library,then detected and analyzed their immune diversity using Shannon entropy,Highly enpended clone(HEC),CDR3 length distribution,and gene length distribution of TCR V region and J region.Results: By detection of experimental samples using HEC,CDR3 length distribution,and gene length distribution of TCR V region and J region,we found there were obvious differences(P<0.05)in TCR immune diversity of the preoperative CRC patients compared with the normal individuals.Analyzing the changes of the TCR immune diversity of perioperative different time points of CRC patients in two groups,we found that TCR immune diversity of the patients experiencing the same anesthetic method for CRC surgery was markedly different(P<0.05)in the third day after operation compared with perioperative other time points.At the perioperative same time points,there were some differences in Shannon entropy,HEC and the R2 value of CDR3 length distribution,and there were marked differences(p<0.05)in some specific CDR3 amino acid sequences,TR?V genes,and combination of V region and J region between the patients in two groups;However,the index of TCR immune diversity of the patients in two groups was nearly recovered to initial level,and was not obviously different between the patients in two groups in the seventh day after operation.Conclusions: Simple general anesthesia or epidural block combined general anesthesia had all significant influence on the TCR immune diversity of perioperative CRC patients.The index of TCR immune diversity of the patients experiencing same anesthsia for CRC surgery was significantly different in the third day after operation compared with perioperative other time points,suggesting that different anesthetic methods had all some effects on TCR immune diversity of perioperative CRC patients,and the effects of the simple general anesthesia on TCR immune diversity was more significant compared with compound anesthesia.Thus,these data demonstrated that the epidural block combined general anesthesia was a more ideal anesthesia method for CRC laparoscopic surgery.