Abstract: Objective:To observe the changes of T,B and NK lymphocyte subsets in peripheral blood of the patients with lung adenocarcinoma in the early stage after single-port thoracoscopic lobectomy, and to explore their relationships with the clinicopathological parameters of the patients and the possible clinical significances. Methods:A total of 66 patients with lung adenocarcinoma who underwent single-port thoracoscopic lobectomy were selected and the peripheral blood was respectively collected on the day of admission (D0),the 1st day (D1) and the 5th day (D5) after operation. The blood cell counter and flow cytometry were used to detect the percentages of CD4+T,CD8+T,CD19+B and CD56+NK lymphocytes. At the same time, the variations of cell percentages of T,B and NK lymphocytes (ΔD0-1,ΔD0-5 and ΔD1-5)before and after operation were calculated, respectively. The correlations between the changes of cell percentages (ΔD0-1,ΔD0-5 and ΔD1-5)of the patients in the early stage after operation and the clinicopathological parameters were analyzed. Results:Compared with D0, the percentages of CD4+T,CD8+T,CD19+B, and CD56+NK lymphocytes in peripheral blood of the patients on D1 and D5 were significantly decreased (P<0.01).The percentages of CD4+T and CD8+T lymphocytes on D5 were significantly higher than those on D1 (t =5.362, P<0.01;t=5.202,P<0.05). The percentages of CD19+B and CD56+NK lymphocytes showed a decreasing trend, but there were no significant differences in the percentages of CD19+B and CD56+NK lymphocytes of the patients between D5 and D1 (P>0.05). The percentage of CD8+ T cells in smokers was lower than that in non-smokers on D0 and D5 (t=2.162, P<0.05;t=1.974,P<0.05).The percentage of CD19+ B lymphocytes in smokers was higher than that in the non-smokers on D0 (t=-1.137,P<0.05). The percentage of CD8+ T lymphocytes in stage T1 was higher than that in stage T2-3 on D0 (t=1.684, P<0.05).The percentage of CD19+ B lymphocytes in stage T1 was higher than that in stage T2-3 (t=1.431, P<0.05), which was in stage Ⅰ higher than that in stage Ⅱ-Ⅲ on D5 (t=2.134, P<0.05).The variation in CD4 + T lymphocyte percentage of the male patients (ΔD1-5) was higher than that of the female patients (t=1.707,P<0.05).The variations in CD8+ T lymphocyte percentage (ΔD0-1 and ΔD0-5) had negative relationship with T stage(r=-0.366,P<0.01;r=-0.252,P<0.05). The variations in CD19+ B lymphocyte percentages (ΔD0-5 and ΔD1-5) of the patients in stage Ⅱ-Ⅲ were higher than those in stage Ⅰ (t=2.075,P<0.05;t=2.140,P<0.05). The variation of cell percentages of CD56+ NK lymphocytes(ΔD0-5) had significantly relationships with the age and smoking status of the patients.The ΔD0-5 in the older patients (≥ 60 years) was lower than that in the younger patients (< 60 years) and the ΔD0-5 in the smokers was lower than those in the non-smokers (t=1.557,P<0.05).The variation of lymphocyte percentage of CD56+ NK (ΔD1-5) had negative relationship with T stage (r=-0.592,P<0.05). Conclusion:The change degrees of percentages of lymphocyte subsets are correlated with the patients' age, gender, smoking status, and T stage.

Key words: lung neoplasms, adenocarcinoma, single-port thoracoscope, lobectomy, lymphocyte subsets, immune function