Changes of Peripheral Lymphocyte Populations in Patients with Advanced/Recurrent Ovarian Cancer Undergoing Splenectomy During Cytoreductive Surgery

Abstract

Background: To investigate the change of peripheral lymphocyte subsets after splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancersMethods: We enrolled 83 patients with advanced or recurrent ovarian cancer who underwent cytoreductive surgery between 09/2016 and 01/2019. Twenty patients who also underwent splenectomy were assigned to the splenectomy cohort and the rest to the non-splenectomy cohort. Flow cytometry was used to measure the 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 not any difference in the number and distribution of peripheral lymphocyte subsets between the two cohorts before surgery. We observed elevated levels of T cells (CD3+, CD3+CD8+) in the splenectomy cohort compared to those in the non-splenectomy cohort after surgery, which achieved statistical significance. The post-operative CD4/CD8 ratio was lower in the splenectomy cohort than in the non-splenectomy cohort (P = 0.048). Regarding the changes of lymphocyte subsets after surgery, CD8+CD28+ T cells had a significant decreasing tendency (P = 0.011) while CD3+/HLA-DR+ T cells were the opposite (P = 0.001) in the splenectomy cohort. In the non-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). The post-operative percentage of CD8+CD28+ T cells was less than the pre-operative one (P = 0.022), which was similar to the splenectomy cohort.Conclusions: The changes of peripheral lymphocyte populations were different between patients with splenectomy and without splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancers. T cells were increased and activated in splenectomy cohort, whereas, B cells were increased and activated in non-splenectomy.