Immunological stress in kidney cancer patients undergoing either open nephrectomy or nephron-sparing surgery: an immunophenotypic study of lymphocyte subpopulations and circulating dendritic cells

Oncol Rep. 2008 Dec;20(6):1511-9.

Abstract

Immunosuppression is a characteristic hallmark of renal cell carcinoma (RCC), with several complex immune defects, almost solely at the level of cell-mediated immune function, well evident even in patients at first diagnosis. The main circulating lymphocyte subsets and the total number of circulating dendritic cells were quantified in 47 RCC patients at diagnosis (T0), 12 h (T1), 24 h (T2) and 8 days following either radical nephrectomy or nephron-sparing surgery using flow cytometry. RCC patients presented, at baseline, (T0) a profound state of immunosuppression involving naïve T-cells, memory T-cells, CD16+ NK and total circulating dendritic cells, that worsened after 12 (T1) and 24 h (T2) from surgery, involving the majority of the analysed subsets; after 8 days (T3) from surgical removal of tumor, however, there was a return of all the analyzed parameters to the basal state. In conclusion, surgery causes transient but relevant immune suppression in RCC patients; even though, by day +8, this tends to return to baseline, immunostimulatory therapies could be considered in the peri-operative setting with the aim of reducing immunosuppression and, hopefully, also disease recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / immunology*
  • Carcinoma, Renal Cell / metabolism
  • Dendritic Cells / metabolism*
  • Female
  • Humans
  • Immunophenotyping / methods*
  • Immunosuppressive Agents / pharmacology
  • Kidney Neoplasms / immunology*
  • Kidney Neoplasms / surgery*
  • Kidney Neoplasms / therapy
  • Lymphocyte Subsets / metabolism
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Nephrectomy
  • Nephrons / metabolism

Substances

  • Immunosuppressive Agents