Relationship of curative surgery on natural killer cell activity in colorectal cancer
Relationship of curative surgery on natural killer cell activity in colorectal cancer
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DOI：
10.1007/bf02054059
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发表时间：
1996-04-01
影响因子：
3.9
通讯作者：
Lledo, S
中科院分区：
文献类型：
--
作者：
Espi, A;Arenas, J;Lledo, S
本研究的目的是评价结直肠肿瘤患者在根治性手术前后的自然杀伤细胞（NK）活性。方法：根据美国癌症联合委员会/国际抗癌联盟分期系统将40例无远处转移的结直肠癌患者分为3类：I期（n = 12），II期（n = 15）和III期（n = 13）。所有患者均行根治性切除，术后无严重并发症。在术前、手术伤口闭合时以及术后第1天、第7天和第21天采集静脉血样。通过Ficoll-Hypaque（TM）（Lymphoprep，Nycomed Pharma AS，奥斯陆，挪威）梯度分离单核细胞，并通过评价针对K562细胞的细胞毒性反应来测定NK活性。15名健康献血员NK活性正常。计算每个术后样本相对于术前水平的百分比相对增量，并使用t检验进行统计学评价。结果：手术前，II期和III期患者的NK活性水平低于健康人（分别为P < 0.05和P < 0.001）。手术后NK活性总是下降（I期：-18.48 +/- 11.42; II期：-16.93 +/- 13.57; III期：-35.29 +/- 12.03，术后第1天），I期患者术后第21天似乎略有上升（+4.87 +/- 12.41）。II期，尤其是III期患者在术后第21天确实显示出显著恢复（分别为+23.63 +/- 9.36和+43.19 +/- 13.34）。此时两组NK细胞活性与正常对照组比较无显著性差异（P > 0.05）。结论：结直肠癌患者NK活性降低与疾病进展有关，即使在局部分期。在II期和III期肿瘤的根治性切除促进了患者NK活性的恢复，术后病程平稳。
Aim of this study has been to evaluate natural killer (NK) activity in patients with colorectal tumors before and after curative surgery. METHODS: Forty colorectal cancer patients without distant metastases were stratified according to American Joint Committee on Cancer/International Union Against Cancer staging system into three categories: Stage I(n = 12), Stage II (n = 15), and Stage III (n = 13). All of them underwent curative resection, and there were no major postoperative complications. Venous blood samples were obtained preoperatively, at surgical wound closure, and on the Ist, 7th, and 21st postoperative days. Mononuclear cells were isolated over Ficoll-Hypaque(TM) (Lymphoprep, Nycomed Pharma AS, Oslo, Norway) gradients, and NK activity was assayed by evaluation of cytotoxic response against K562 cells. Normal NK activity was achieved from 15 healthy donors. Percentage relative increments in relation to preoperative levels were calculated for every postoperative sample, and t-test was used for statistical evaluation. RESULTS: Before surgery, Stages II and III patients had lower levels of NK activity than healthy people (P < 0.05 and P < 0.001, respectively). NK activity always fell after surgery (Stage I: -18.48 +/- 11.42; Stage II: -16.93 +/- 13.57; Stage III: -35.29 +/- 12.03, at day 1 postsurgery) and appeared to rise slightly by the 21st postoperative day in Stage I patients (+4.87 +/- 12.41). Stage II, and especially Stage III, patients did show a significant recovery by the 21st postoperative day(+23.63 +/- 9.36 and +43.19 +/- 13.34, respectively). At this time, NK activity in these two groups was not significantly lower than in normal subjects (P > 0.05). CONCLUSION: NK activity is depressed in colorectal cancer patients in relation to progression of illness, even at locoregional stages. Curative resection of tumors at Stages II and III has promoted a recovery of NK activity in patients with uneventful postoperative courses.