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Twenty-five patients consented and had specimens collected. Initially, peripheral blood of 21 patients was collected for circulating immune cell studies. Two of these patients were excluded due to technical issues, leaving 19 patients for the analyses of circulating immune cells. Standard gating and high-dimensional unsupervised clustering flow cytometry analyses were performed. The blood, tumors and lymph nodes were analyzed via single-cell RNA and TCR sequencing for Treg analyses in a total of five patients (including four additional patients from the initial 21 patients). Standard gating flow cytometry revealed a transient increase in neutrophils immediately following surgery, with a variable neutrophil\u2013lymphocyte ratio and a stable CD4\u2013CD8 ratio. Unexpectedly, the total Treg and Treg subsets did not change with surgery with standard gating in short- or long-term follow-up. Similarly, unsupervised clustering of Tregs revealed a dominant cluster that was stable perioperatively and long-term. Two small FoxP3hi clusters slightly increased following surgery. In the longer-term follow-up, these small FoxP3hi Treg clusters were not identified, indicating that they were likely a response to surgery. Single-cell sequencing demonstrated six CD4+FoxP3+ clusters among the blood, tumors and lymph nodes. These clusters had a variable expression of FoxP3, and several were mainly, or only, present in tumor and lymph node tissue. As such, serial monitoring of circulating Tregs may be informative, but not completely reflective of the Tregs present in the tumor microenvironment.<\/jats:p>","DOI":"10.3390\/curroncol30050387","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T10:01:13Z","timestamp":1684404073000},"page":"5116-5134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Effect of Lung Resection for NSCLC on Circulating Immune Cells: A Pilot Study"],"prefix":"10.3390","volume":"30","author":[{"given":"Joseph D.","family":"Phillips","sequence":"first","affiliation":[{"name":"Department of Surgery, Dartmouth-Hitchcock Medical Center, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla A.","family":"Fay","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dartmouth-Hitchcock Medical Center, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan J.","family":"Bergeron","sequence":"additional","affiliation":[{"name":"DartLab, Dartmouth Cancer Center, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peisheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"DartLab, Dartmouth Cancer Center, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8784-8386","authenticated-orcid":false,"given":"Daniel W.","family":"Mielcarz","sequence":"additional","affiliation":[{"name":"DartLab, Dartmouth Cancer Center, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Calkins","sequence":"additional","affiliation":[{"name":"DartLab, Dartmouth Cancer Center, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler G.","family":"Searles","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brock C.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology and Molecular & Systems Biology, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Finley","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dartmouth-Hitchcock Medical Center, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jo","family":"Turk","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline Y.","family":"Channon","sequence":"additional","affiliation":[{"name":"DartLab, Dartmouth Cancer Center, Lebanon, NH 03756, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organisation (2021, May 18). 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