IMMUNOLOGICAL PARAMETERS IN PERIPHERAL-BLOOD OF PATIENTS WITH RENAL-CELL CARCINOMA BEFORE AND AFTER NEPHRECTOMY

Objective To determine the effects of nephrectomy on the immune respon se of patients with renal cell carcinoma (RCC). Patients and methods F ive patients with RCC were monitored before and oner a period of up to 3 months after nephrectomy. The aspects measured were the phenotypic expression of markers on circulating lymphocytes, circulating concentr ations of cytokines, markers of inflammatory and immune responses, and natural killer (NK) cell and lymphokine-activated killer (LAK) cell a ctivity in peripheral blood mononuclear cells (PBMC). The suppressive activity of patients' plasma on NK activity and ability to generate in terleukin-2 (IL-2) induced LAK cells in PBMC of normal volunteers was also investigated. Results The results indicated that high CD4/8 ratio s were present pre-nephrectomy with evidence of inflammatory responses and immune activation in some patients, particularly those with metas tatic disease. Conclusion The effect of nephrectomy was to decrease th e inflammatory response and increase immune activation. Various defect s in NK cell activity and LAK cell generation were demonstrated pre-su rgery which slowly improved once the primary tumour had been removed a nd it is suggested that such defects could have contributed to tumour growth and development due to an ineffective immune response.