Abstract:
Objective To explore the role of NKG2D ligand MHC-I related molecule A (MICA) in chemotherapy combined with NK cell immunotherapy in patients with advanced esophageal cancer after surgery.
Methods A total of 90 patients with esophageal cancer from Fujian Provincial Tumor Hospital were divided into three groups after surgery: 40 patients of chemotherapy alone, 25 patients of chemotherapy combined with NK cell therapy with negative expression of MICA (MICA- group), and 25 patients of chemotherapy combined with NK cells therapy with positive expression of MICA (MICA+ group). The efficacy was then compared.
Results Compared with the chemotherapy alone and MICA- groups, the positive rates of CD3+, CD4+ T cells, NK cells, and the CD4+/CD8+ ratio in peripheral blood from MICA+ group were higher than those before treatment (64.2% ± 6.4% vs. 51.3% ± 5.6%, 39.8% ± 8.2% vs. 29.5% ± 3.2%, 25.3% ± 2.1% vs. 16.4% ±4.3%, 1.4% ± 0.5% vs. 1.1% ± 0.7%; P < 0.05). Meanwhile, the levels of T-reg cells were lower than those before treatment (6.3% ± 4.5% vs. 17.3% ± 2.4%, P < 0.05). No significant difference was observed between the disease control rate and response rate. Chemotherapy-induced neutropenia and peripheral neurotoxicity symptoms were significantly improved, and time to progression (TTP) and overall survival (OS) were significantly prolonged (P < 0.05). No statistically significant difference was observed between the chemotherapy alone group and MICA-group (P>0.05).
Conclusion Treatment with chemotherapy and autologous NK cells on patients with advanced esophageal carcinoma and MICA positive expression can be safely transfused with only minor side effects and can effectively improve a patient's immune system, quality of life, and survival.
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