Objective To evaluate the expression of programmed cell death 1 (PD-1) and lymphocyte activation gene 3 (LAG-3) in lymphocytes following surgery for advanced adenocarcinoma of esophagogastric junction(AEGJ), and to understand the effect of radical surgical trauma on cellular immune function.

Methods On 102 patients with advanced AEGJ, open radical R0 resection and D2 lymph node dissection were performed. The expression level of PD-1 and LAG-3 in T cells were measured by flow cytometry.

Results Compared with the control group, preoperative CD3⁺, CD3⁺CD4⁺ T lymphocytes were significantly decreased (P < 0.05), and the proportion of PD-1 and LAG-3 in CD4⁺ and CD8⁺ T cells was significantly increased (P < 0.05) in the treatment group. The proportion of CD4⁺PD-1⁺ T lymphocytes was significantly increased after surgery, reaching a maximum on postoperative day 1, but the proportion was still significantly higher on day 7 that before surgery. The proportion of CD8⁺PD-1⁺ T lymphocytes was gradually increased after surgery and reached a maximum on day 7. The proportion of CD4⁺LAG 3⁺ T cells in peripheral venous lymphocytes showed a gradually increasing trend after surgery, but it was only significantly higher during 7 days after surgery than that before surgery (t=2.199, P=0.029). There was a slight change in the proportion of CD8⁺LAG 3⁺ T cells in peripheral venous lymphocytes, but the difference was not statistically significant (P > 0.05).

Conclusion The surgical trauma of AEGJ may lead to the change in the proportion of CD4⁺ PD-1⁺ T cells through various cytokines, so as to regulate the proportion of T lymphocyte subpopulation and inhibit the cellular immunity.