Circulating dendritic cells and development of septic complications after pancreatectomy for pancreatic cancer

Objective: To investigate whether circulating dendritic cells in patients with pancreatic cancer is a risk factor for septic complications after pancreatectomy. Design: Retrospective study. Setting: University hospital. Patients: Forty-one patients with pancreatic cancer who underwent pancreatectomy from May 2001 to July 2005. Patients were divided into 2 groups depending on whether or not they had a development of postoperative septic complications. Main Outcome Measures: Dendritic cell, natural killer cell, and CD4(+) T-cell, and CD8(+) T-cell counts were measured preoperatively in each patient. Clinicopathologic parameters and immune parameters for each patient, operation, and tumor were compared between the 2 groups. Preoperative risk factors for postoperative septic complications were determined using logistic regression analysis. Results: Circulating dendritic cell count before pancreatectomy in patients with septic complications postoperatively for pancreatic cancer was significantly lower than in patients without septic complications. Multivariate analysis indicated that preoperative circulating dendritic cell count was the only predictive value among the diverse clinical parameters tested in relation to the development of septic complications. Notably, when the circulating dendritic cell count was less than 10.0 x 10(3)/mL in the peripheral blood, the risk of developing postoperative septic complications markedly increased. In such cases, the sensitivity, specificity, positive predictive value, and negative predictive value of total circulating dendritic cell count were as high as 80%. Conclusion: In patients with pancreatic cancer, low preoperative circulating dendritic cell count (< 10.0 x 10(3)/mL) is a significant risk factor for the development of septic complications after pancreatectomy.