The effect of major surgery on T-lymphocyte function in patients with gastrointestinal cancer

THE effect of major surgery on immune function in 24 patients with gastrointestinal malignancies was assessed with particular regard to T-lymphocyte responsiveness as measured by blastogenic responses to phytohaemagglutinin (PHA) and concanavalin A (Con A). The influence of surgery on T-lymphocyte subsets, i.e. the proportion of T-helper (TH) and T-suppressor (Ts) cells, was also evaluated. For periods of time up to two weeks post-operatively, there appeared to be no significant effect of surgery on T-lymphocyte function as assessed by responses to PHA and Con A, the responsiveness of the group remaining at preoperative depressed levels. The helper/suppressor T-lymphocyte ratios increased marginally in the early post-operative period and subsequently reverted to the lower than normal pre-operative values. The major effect of surgery in cancer patients appeared as a decline at 14 days in total T-cells, expressed as a percentage of total mononuclear cells, from 62.2% to 54.6%,with a smaller decrease from 40.0% to 36.9%, in the proportion of TH in the overall T-cell population.