Perioperative dynamics of siglec-15 and soluble PD-L1 in ovarian cancer surgery: Influence of anaesthetic technique on immune regulation

Abstract

This prospective observational study investigated the perioperative dynamics of circulating sialic acid-binding immunoglobulin-like
lectin 15 (SIGLEC-15) and soluble programmed death-ligand 1 (sPD-L1) in patients with ovarian cancer undergoing surgery with
either total intravenous anesthesia or inhalational anesthesia. Patients were consecutively enrolled, and peripheral blood samples
were collected at predefined perioperative time points. Biomarker levels were measured and compared between anesthesia groups,
and their associations with immune and inflammatory parameters were analyzed using appropriate statistical methods. Following
surgery, levels of SIGLEC-15 and soluble programmed death-ligand 1 increased significantly, peaking at 24 hours and remaining
elevated at 72 hours, with more pronounced changes observed in the inhalational anesthesia group. Elevated biomarker levels were
associated with greater immune dysregulation, reflected by alterations in natural killer cell proportion, CD4 to CD8 T-cell ratios,
and increased levels of interleukin-6 and cortisol. These findings suggest that SIGLEC-15 and soluble programmed death-ligand 1
may serve as blood-based indicators of perioperative immune status. However, their long-term clinical significance requires further
investigation. Overall, this study underscores the importance of dynamic monitoring of immune biomarkers during the surgical
period to better understand their role in ovarian cancer management.