Immune function in malignant cervical neoplasia: A multiparameter analysis

Balaram, Prabha; Pillai, M. Radhakrishna; Padmanabhan, T. K.; Abraham, Thomas; Hareendran, N.K.; Nair, Muralidharan

doi:10.1016/s0090-8258(88)80025-8

Cited by 37 publications

(12 citation statements)

References 27 publications

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“…Previous studies have demonstrated that a strict rela tionship exists between the immune system and initiation and growth of neoplasia [1][2][3]. Cellular immune re sponses are mediated by T lymphocytes and natural killer (NK) cells, which are important effectors in antitumor and antiviral resistance.…”

Section: Introductionmentioning

confidence: 99%

Natural Killer Cell Activity in Patients with Gynecologic Malignancies: Correlation with Histologic Grading and Stage of Disease

Garzetti

Cignitti²,

Marchegiani³

et al. 1992

Gynecol Obstet Invest

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Basal natural killer (NK) cell activity in peripheral blood lymphocytes (PBLs) of 29 patients with gynecologic malignancy and 10 healthy controls was performed using K 562 cell line. A significant decrease of NK cell activity was observed in patients with gynecologic malignancy (p = 0.003). The NK cell activity of patients with poorly differentiated tumor or with stage IV of disease was significantly reduced with respect to patients at any other lower grade or earlier stage. We conclude that in patients with gynecologic malignancies there is a decrease of basal NK cell activity of PBLs, which is more significant in cases of distant tumor dissemination or poorly differentiated tumor (p < 0.001).

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Section: Introductionmentioning

confidence: 99%

Natural Killer Cell Activity in Patients with Gynecologic Malignancies: Correlation with Histologic Grading and Stage of Disease

Garzetti

Cignitti²,

Marchegiani³

et al. 1992

Gynecol Obstet Invest

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“…The NK cell activity in 4 patients who had undergone previous penile amputation was 11,18, 21 and 32.1% at an effector to target cell ratio of 100:1, and 9, 13.5, 18.2 and 21.1% at an effector to target cell ratio of 50:1. These patients presented with inguinal metastases demonstrated by inguinal lymphadenectomy performed in our institute.…”

Section: Resultsmentioning

confidence: 94%

“…While certain authors have found decreased levels of NK cell activity in patients with lower stages of cervical carcinoma [10][11][12] and others have found no difference between these patients in the early stages of disease and healthy groups [3], some authors have found high NK activity in patients with uterine cervix carcinoma and Hodgkin's disease [13,14].…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of Natural Killer Cytotoxicity in Patients with Squamous Cell Carcinoma of the Penis

Campos

Souza²,

Pires³

et al. 1998

Nat Immun

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Impairment of natural cytotoxicity mediated by natural killer (NK) cells may play a role in the pathogenesis of penile carcinoma. The aim of this study was to examine the NK activity profile and its prognostic significance in patients with squamous cell carcinoma of the penis. The NK activity was measured in peripheral blood mononuclear cells (PBMCs) from 39 patients diagnosed histologically as having invasive squamous cell penile carcinoma and 4 patients with verrucous carcinoma of the penis. Of 39 patients with invasive squamous cell carcinoma, 4 had undergone previous penile amputation. According to the prognosis, the patients with invasive squamous cell carcinoma were divided into two groups: with metastasis and without metastasis. The patients were evaluated in relation to clinicopathologic variables using univariate analyses. NK cell activity was significantly decreased in all patients with penile carcinoma when compared with the control groups (p < 0.0001). There was no statistically significant difference between the groups with and without metastasis. We conclude that there is a decrease in NK activity in PBMCs from patients with penile carcinoma and that the presence of advanced disease or metastatic involvement is not responsible for this reduction.

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“…It is therefore possible that these alterations in immunologic function may prevent or reduce the ability of cervical cancer patients to eliminate embolic populations of tumor cells at the time of radiation treatment. This possibility could be particularly important in cervical cancer patients, since (1) it has been established that the majority of cervical tumors carry HPV and peptides encoded by HPV may be antigenic [30][31][32]; (2) more than 50% of patients with locally advanced cervical cancer may have detectable tumor cells in the circulation at the time of treatment [36]; (3) radiation therapy is known to have profound and long-lasting immunosuppressive effects on host immunity, and (4) a correlation between the immunological competence of the host and clinical outcome has previously been shown for this human tumor [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, it is possible that an additive immunosuppressive effect of blood transfusion on that of radiation, weakening host immune system tumor interactions, might negate or reduce the therapeutic benefit obtained by the increased tumor cell killing due to improved cell oxygenation. These negative effects could be particularly important in the treatment of an immunogenic tumor such as cervical cancer, where the correlation between the immunological competence of the host and clinical outcome has been previously shown [23,24]. In this retrospective analysis we have evaluated the relationship between blood transfusion and long-term survival in 130 consecutive patients with stage-IIB and -III cervical cancer treated with external radiation and intracavitary curie therapy with or without concomitant cisplatinum administration between 1990 and 1999 at the University of Arkansas for Medical Sciences.…”

Section: Introductionmentioning

confidence: 99%

Influence of Allogeneic Blood Transfusion on Clinical Outcome during Radiotherapy for Cancer of the Uterine Cervix

Santin

Bellone

Parrish

et al. 2003

Gynecol Obstet Invest

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Anemia has long been reported to adversely affect the efficacy of radiation treatment in cervical cancer. On the basis of these findings, many radiation oncologists routinely use blood transfusions with the intent to maintain hemoglobin above specified levels during radiation therapy. However, allogeneic blood transfusions have been previously linked with biological and clinical phenomena correlated with immune suppression. In this study we have analyzed the effects of blood transfusion on the outcome of 130 patients with stage-IIB and -III cervical carcinomas treated with external radiation and intracavitary brachytherapy with or without concomitant platinum administration at the University of Arkansas for Medical Sciences between 1990 and 1999. With the exception of hemoglobin and hematocrit levels at the onset of treatment between the transfused and untransfused groups (p < 0.001), the distribution of age, histology, total radiation dose and duration of treatment were not significantly different between the 2 groups of stage-IIB and -III patients. Among the 45 stage-IIB patients who received blood during radiation treatment, there were 31 deaths (68.8%), compared with 14 (31.8%) among the 44 patients who did not receive blood (p > 0.05). Among the 30 stage-III patients who received blood during radiation treatment, there were 27 deaths (90%), compared with 6 (54%) among the 11 patients who did not receive blood (p > 0.11). In multivariate analysis of survival, there was a significant difference due to transfusion with a risk ratio (RR) of 2.6 (95% CI 1.6, 4.2; p < 0.001) after adjusting for no chemotherapy (RR = 2.2, 95% CI 1.4, 3.5; p < 0.001), considering all patients collectively, stage-IIB patients only (RR = 1.9, 95% CI 1.1, 3.3; p < 0.01), and stage-III patients only (RR = 3.2, 95% CI 1.2, 8.7; p < 0.02). These results suggest that routine blood transfusion of anemic cervical cancer patients does not improve outcome and may represent an independent variable predictive of diminished survival during primary radiation treatment for cervical cancer. Prospective randomized studies are strongly warranted to confirm this hypothesis.

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Immune function in malignant cervical neoplasia: A multiparameter analysis

Cited by 37 publications

References 27 publications

Natural Killer Cell Activity in Patients with Gynecologic Malignancies: Correlation with Histologic Grading and Stage of Disease

Natural Killer Cell Activity in Patients with Gynecologic Malignancies: Correlation with Histologic Grading and Stage of Disease

Clinical Implications of Natural Killer Cytotoxicity in Patients with Squamous Cell Carcinoma of the Penis

Influence of Allogeneic Blood Transfusion on Clinical Outcome during Radiotherapy for Cancer of the Uterine Cervix

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