We have demonstrated that thoracoscopic talc poudrage (TTP) induces peripheral blood granulocytosis and lymphopenia. The aim of this study is to investigate whether lymphopenia concerns T-, or B-lymphocytes.
We measured lymphocytes of the peripheral blood in patients who underwent TTP, before (baseline), at 24h and 48h after the procedure. Absolute lymphocyte numbers were analysed by flow cytometry for the evaluation of the CD3+, CD4+, CD8+ cells (total T-lymphocyte, helper T-lymphocytes, cytotoxic T-lymphocytes respectively), the CD19+ cells (B-lymphocytes), and the CD16+, CD56+ and CD57+ cells (NK-cells). No anti-inflammatory medication was permitted before, during or after the procedure. To this day 11 patients have been analysed. We used ANOVA repeated measurements for statistical analysis.
The mean age of our patients was 65.5±15.8 years. Male patients were 6 (54.5%). All patients but one had carcinomatous pleural effusion (91%). The overall lymphocytes count was significantly decreased from baseline in peripheral blood (p=0.007). Also, the CD3+, CD4+ and CD8+ count were significantly decreased from baseline in the peripheral blood (p=0.005, 0.02 and 0.03 respectively). No significant difference was found in the absolute number of CD19+, CD16+, CD56+, and CD57+ cells.
Patients undergoing TTP display peripheral blood T-lymphopenia following the procedure, probably due to enhanced extravasation in the pleura. The duration of the lymphopenia and the possible effect on the inflammatory process of pleurodesis is under investigation.
To understand the systemic effects of thoracoscopic talc pleurodesis.This study is in part supported by a grant from Pierre Fabre Farmaka.
Marios Froudarakis, None.