Cellular immune level changes of patients with different grades of glioma in perioperative period and its relationship with postoperative intracranial infection

Abstract

Objective To detect the changes of cellular immune level in patients with different grades of glioma in perioperative period, and to investigate its relationship with the postoperative intracranial infection. Methods A total of 53 patients with glioma newly diagnosed by pathology who underwent the surgical treatment in the First Hospital of Shanxi Medical University from September 2017 to September 2018 were collected. According to the World Health Organization (WHO) classification criteria, the patients were divided into the low-grade group (grade Ⅰ-Ⅱ, 21 cases) and the high-grade group (grade Ⅲ-Ⅳ, 32 cases). The peripheral blood at the time of 1 day before the operation, 1 day and 7 days after the operation was drawn to detect the T lymphocyte subsets, and then the differences of cell immunity indexes from different grade gliomas were analyzed. The relationship between immune level and postoperative intracranial infection was analyzed. SPSS 22.0 statistical software was used to analyze the data. Results The levels of CD3+, CD4+, CD8+, CD4+ CD25+ Foxp3+ and CD4+/CD8+ in the high-grade group at the time of 1 day before the operation were (54.09±4.25)%, (31.93±3.08)%, (34.23±2.48)%, (9.66±1.47)%, 0.93±0.06, respectively; the levels at the time of 1 day after the operation were (48.84±3.69)%, (27.49±2.41)%, (34.99±2.96)%, (11.09±1.70)%, 0.84±0.05, respectively; the levels at the time of 7 days after the operation were (59.45±3.47)%, (33.59±2.66)%, (31.99±1.97)%, (7.45±1.48)%, 1.05±0.07, respectively. The levels of CD3+, CD4+, CD8+, CD4+ CD25+ Foxp3+ and CD4+/CD8+ in the low-grade group at the time of 1 day before the operation were (62.37±6.57)%, (34.88±4.43)%, (30.16±3.75)%, (6.30±1.29)%, 1.16±0.11, respectively; the levels at the time of 1 day after the operation were (55.44±7.25)%, (29.05±4.04)%, (31.66±3.13)%, (7.95±1.67)%, 0.92±0.11, respectively; the levels at the time of 7 days after the operation were (67.73±7.18)%, (35.55±4.95)%, (28.10±3.12)%, (5.50±1.25)%, 1.27±0.12, respectively. The levels of CD3+, CD4+, CD4+/CD8+ before and after the operation in the high-grade group were lower than those in the low-grade group (all P < 0.05), while the levels of CD8+ and CD4+ CD25+ Foxp3+ were higher than those in the low-grade group (all P < 0.05). Compared with the levels at the time of 1 day before the operation, the levels of CD3+, CD4+, CD4+/CD8+ at the time of 1 day after the operation of both groups were decreased, while the levels of CD8+ and CD4+ CD25+ Foxp3+ were increased (all P < 0.05). The levels of CD3+, CD4+ and CD4+/CD8+ at the time of 7 days after the operation in the both groups were increased, while the levels of CD8+ and CD4+ CD25+ Foxp3+ were decreased (all P < 0.05). Among 53 patients, 8 cases had postoperative intracranial infection, and the infection rate was 15.09%. Age, duration of surgery, pathological stage, and intraoperative blood transfusion were the independent affecting factors of postoperative intracranial infection of cerebral glioma (OR=1.513, P=0.024; OR=1.722, P < 0.01; OR=1.365, P=0.001; OR=1.262, P < 0.01). Conclusions The peripheral blood cellular immune level of glioma patients is related with the malignancy of glioma. The inhibition degree of the cellular immunity could be relieved after the resection of glioma. The detection of T lymphocyte subsets could be considered as an evaluating index for the malignancy and prognosis in patients with glioma. The clinical detection of cellular immune can play a positive role in predicting and preventing the postoperative intracranial infection in patients with glioma. Key words: Glioma; T-lymphocyte subsets; Regulatory T cell; Postoperative infection