Effect of operation on peripheral lymphocyte counts and production of adenosine triphosphate (ATP) in cancer patients

Abstract

Lymphocyte bioenergetics in cancer patients undergoing surgery is largely unexplored. The effect of surgery on total lymphocyte counts and adenosine triphosphate (ATP) production is reported. Lymphocyte ATP was assayed by the coupled enzymatic method using hexokinase and glucose 6-phosphate dehydrogenase and lymphocyte counts were calculated from total leukocyte counts and differential counts. Lymphocyte ATP assay and counts were carried out in 13 patients pre- and postoperatively, and lymphocyte counts were scored in six more patients similarly. In 69% of the patients lymphocyte ATP production was depressed postoperatively, and this condition appeared to be associated with cancer spread and immunosuppressive tumors. Postoperative increase in lymphocyte ATP was observed following hysterectomy, colostomy, and also after blood transfusion. The significance of the findings are discussed. Changes in postoperative lymphocyte counts correlated with lymphocyte ATP in 62% of the cases.

A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection

“…Depression in T-cell function may attenuate the tumour specific response. Major surgery in cancer patients is known to reduce lymphocyte metabolism, as measured by adenosine triphosphate production, which leads to functional impairment [28]. In addition, the microenvironment within the tumour can also influence on the invading leukocytes to enhance angiogenesis, invasion, motility and viability [6,7,29,30].…”

Negative impact of low body mass index on surgical outcomes after hepatectomy for hepatocellular carcinoma

“…Moreover, the low‐BMI group had a reduced perioperative lymphocyte count, a high incidence of poorly differentiated or multiple HCCs, and had a high CLIP score compared with patients with a standard BMI. The reduced lymphocyte count suggests immunological suppression [], while poorly differentiated and multiple HCCs are indicative of highly malignant tumors. Patients with a low BMI had a higher CLIP score and increased expression of malignant tumors, possibly due to worse nutritional and immunological status in comparison with the control group; conversely, the patients' poor nutritional and immunological conditions may be a result of the more‐malignant tumors.…”

“…Hepatic reserve was assessed using the Child–Pugh classification [21], platelet count, and indocyanine green retention rate at 15 min (ICG R 15 ). Patients' immunological states were assessed by the absolute counts of peripheral blood leukocytes and lymphocytes []. Blood tests were routinely performed on the day of admission and on postoperative days 1, 3, and 7.…”

Stratified neutrophil-to-lymphocyte ratio accurately predict mortality risk in hepatocellular carcinoma patients following curative liver resection

“…The recent meta-analyses have confirmed the prognostic value of the NLR in HCC [ 29 ]. In addition, surgery in cancer patients has been shown to influence lymphocyte function, including reducing lymphocyte adenosine triphosphate production following hysterectomy, colostomy, and also after blood transfusion [ 30 ]. This was also been observed in HCC patients after CLR, some studies indicate that pre-operative NLR was an adverse predictor of disease-free and overall survival in these patients [ 21 , 31 ].…”