自体肿瘤杀伤活性作为原发性切除非小细胞肺癌预后因素的研究

Autologous tumor killing activity as a prognostic factor in primary resected nonsmall cell carcinoma of the lung.

作者信息

Fujisawa T, Yamaguchi Y

机构信息

Department of Surgery, Chiba University School of Medicine, Japan.

出版信息

Cancer. 1997 Feb 1;79(3):474-81.

PMID:9028357

Abstract

BACKGROUND

Cytotoxic activity of peripheral blood lymphocytes obtained during surgery against autologous fresh tumor cells has been reported. However, the role of lymphocyte autologous tumor killing or natural killer activity during the postoperative period remains obscure. In this article, the authors describe the importance of postoperative autologous tumor killing activity as a prognostic factor in patients with primary resected nonsmall cell lung carcinoma (NSCLC) after long term follow-up.

METHODS

Forty-two patients who had resection of NSCLC, with primary culture of autologous tumor cells taken successfully, were studied. Cytotoxic activity against autologous, allogenic NSCLC and K562 leukemia cells was examined using peripheral blood lymphocytes obtained during the 2 weeks immediately following surgery. Factors related to prognosis were analyzed by univariate and multivariate analyses.

RESULTS

The overall 5- and 10-year survival rates for the NSCLC patients were 40.5% and 27.5%, respectively. Statistical analysis of survival curves revealed a significant difference with regard to T classification (P = 0.025), N classification (P = 0.0015), stage (P = 0.028), and postoperative autologous tumor killing activity (P = 0.0008); there were no significant differences in relation to age, gender, histology, differentiation, visceral pleural invasion, resectability, surgical method, allogeneic tumor killing activity, or natural killer activity. Multivariate analysis demonstrated a significant correlation between disease recurrence and N classification (P = 0.0003), T classification (P = 0.023), stage (P = 0.001), and autologous tumor killing activity (P = 0.007), indicating independent prognostic significance. The phenotypes of the effector cells involved in autologous tumor killing activity were CD3(+), CD4(-), CD8(+), and CD11b(-). Autologous tumor killing activity was inhibited by competing unlabeled autologous tumor cells.

CONCLUSIONS

Autologous tumor killing activity during the 2 weeks immediately following surgery is an important prognostic factor in resected NSCLC.

摘要

背景

已有报道称手术期间获取的外周血淋巴细胞对自体新鲜肿瘤细胞具有细胞毒性活性。然而，淋巴细胞自体肿瘤杀伤或自然杀伤活性在术后阶段的作用仍不明确。在本文中，作者描述了术后自体肿瘤杀伤活性作为长期随访后原发性切除非小细胞肺癌（NSCLC）患者预后因素的重要性。

方法

研究了42例成功进行NSCLC切除并成功进行自体肿瘤细胞原代培养的患者。使用术后立即2周内获取的外周血淋巴细胞检测对自体、同种异体NSCLC和K562白血病细胞的细胞毒性活性。通过单因素和多因素分析分析与预后相关的因素。

结果

NSCLC患者的总体5年和10年生存率分别为40.5%和27.5%。生存曲线的统计分析显示，在T分类（P = 0.025）、N分类（P = 0.0015）、分期（P = 0.028）和术后自体肿瘤杀伤活性（P = 0.0008）方面存在显著差异；在年龄、性别、组织学、分化、脏层胸膜侵犯、可切除性、手术方法、同种异体肿瘤杀伤活性或自然杀伤活性方面无显著差异。多因素分析表明疾病复发与N分类（P = 0.0003）、T分类（P = 0.023）、分期（P = 0.001）和自体肿瘤杀伤活性（P = 0.007）之间存在显著相关性，表明具有独立的预后意义。参与自体肿瘤杀伤活性的效应细胞表型为CD3(+)、CD4(-)、CD8(+)和CD11b(-)。自体肿瘤杀伤活性受到未标记的自体肿瘤细胞竞争的抑制。