The Difference Between Video-assisted Thoracoscopic Surgery And Traditional Thoracic Surgery On Peripheral Blood T Lymphocyte Subsets And NK Cells In Patients With Lung Cancer

Objectives:To compare the effects of two surgical methods on immune function in patients with lung cancer.And from the perspective of immunology to explore the significance of thoracoscopic surgery in the treatment of lung cancer.Methods: Totally 60 patients who suffered from non small-cell lung cancer of Ⅰ or Ⅱa stage , Meanwhile The general data of 60 patients were collected, including age, sex,pathological type, TNM stage, tumor diameter, intraoperative blood loss,out of bed postoperative time and Pain score. in the surgical treatment of indications, dividing into traditional thoracic surgery (TTS group) 30 cases, another 30 cases of video-assisted thoracoscopic surgery group (VATS group), the levels of T cell subsets(the levels of CD3+T、CD4+T、CD8+T、CD4+T/CD8+T ratio )and NK cells in peripheral blood were measured by flow cytometry 1 day before operation and the first day after operation, the second days after operation, the fifth days after operation,the 30th days after operation. And all the Data were analyzed using spss22.0 for statistical analysis,The count data are described by the number of cases,and the measurement data are described by the mean addition and subtraction standard deviation,The difference between the two groups was analyzed by independent sample t test, chi-square test and fisher precise probability method,At the same time,the difference of immunological indexes between the two groups was analyzed by independent sample t test,The difference of immunological indexes between different time points in the same group was analyzed by paired t test,P <0.05 for the difference was statistically significant.Results: There was no significant difference between VATS group and TTS group in terms of gender,age,operation time,TNM stage,pathological type and tumor diameter(P>0.05 ) , but the intraoperative blood loss, out of bed postoperative time and Pain score, VATS group was significantly better than TTS group, the difference was statistically significant(P<0.05);There was no significant difference in CD3+T,CD4+T, CD8+T, CD4+T/CD8+T ratio and NK cells level between VATS group and TTS group before operation (P> 0.05). VAT group and TTS group CD3+T, CD4+T,NK cells level, 1-5 days after surgery compared with 1 day before surgery, the difference was statistically significant (P<0.05), VATS group and TTS group CD3+T,CD4+T,CD4+T/CD8+T ratio were significantly different between the 30th day after operation and before operation (P<0.05). There were significant differences in CD3+T,CD4+T/CD8+T ratio, NK cells between TTS group and VATS group (P <0.05) on the first day after operation. The ratio of CD3+T, CD4+T, CD4+T/CD8+T in VATS group was significantly different from that in TTS group on the 3rd day and the fifth day after operation(P<0.05). There was no significant difference in the ratio of CD3+T,CD4+T, CD8+T, CD4+T /CD8+T between VATS group and TTS group at 30 days after operation (P>0.05). At 30 days after operation,the NK cells level was significant difference between VATS group and TTS group (P <0.05).Conclusions:1.Intraoperative blood loss, get out of bed time, postoperative pain and lung cancer patients after surgery changes in immune function are related.2. thoracoscopic surgery than the traditional thoracic surgery on the immune system less affected, and postoperative immune function recovery faster.