NATURAL-KILLER-CELL ACTIVITY IN PATIENTS WITH INVASIVE CERVICAL-CARCINOMA - IMPORTANCE OF A LONGITUDINAL EVALUATION IN FOLLOW-UP

Objective: To analyze longitudinally the basal natural killer cell act ivity in patients with invasive cervical carcinoma, the natural cytoto xicity was related to the most important known prognostic factors, and evaluated with respect to the clinical outcome of cervical disease. M aterials and Methods. Forty-six patients with histologically proven in vasive cervical carcinoma treated and followed at the Institute of Gyn ecology and Obstetrics, Ancona University, Salesi Hospital, were conse cutively recruited from 1989 to 1992 and included into the study. For immunologic investigation, natural killer cell activity and peripheral blood T-lymphocyte subsets were tested before primary treatment and d uring the follow-up period, every 6 months. Natural killer activity wa s determined by target cell retention of the fluorescent dye carboxyfl uorescein diacetate; the K 562 cell line was used as target cells. Res ults: A significant inverse relationship was observed between natural killer activity and disease stage (p = 0.001); patients with stage IV disease had the lowest level of natural cytotoxicity. The reduction of natural cytotoxicity was not accompanied by any alteration of lymphoc yte distribution. The longitudinal analysis showed an increase of natu ral killer activity after surgical removal of the tumor, persisting du ring the follow-up, but all the 9 patients who recurred showed, at the time of disease recurrence, a significant decrease of their natural c ytotoxic potential. Conclusion: Natural killer cell activity seems to be a functional index of immune status, significantly related to the s tage and the clinical out-come of disease.