Abstract
Background: Cancer patients have often been reported to have impaired immune function, and the effect of treatment modalities, such as surgery, irradiation, and chemotherapy, in depressing patients’ immunity has also been reported. In this investigation, the effect of treatment on the cellular immunity of esophageal cancer patients was evaluated.
Methods: Immunological parameters, such as natural killer (NK) activity and lymphocyte subsets in peripheral blood, were measured in 32 esophageal cancer patients on 5 occasions (on the day of admission, 2 days before surgery, and 1 week, 1 month, and 2 months after surgery).
Results: NK activity was greatly impaired shortly after the operation, and the percentages of lymphocytes as a whole, and CD8+, CD16+, and CD57+ lymphocytes were significantly decreased, on the other hand, a postoperative increase in the CD4+/CD8+ ratio was observed. No significant depression of immune function by postoperative irradiation was observed.
Conclusions: The results of this study suggest that cellular immunity, especially cytotoxicity, shortly after esophagectomy may be greatly impaired by the surgical stress of esophagectomy and an added effect of chemotherapy.
Similar content being viewed by others
References
Collard JM, Otte JB, Reynaert MS, et al. Extensive lymph node clearance for cancer of the esophagus or cardia: merits and limits in reference to 5-year absolute survival.Hepatogastroenterology 1995;42:619–27.
Kelsen DP, Ginsberg R, Pajak TF, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer.N Engl J Med 1998;339:1979–84.
Japanese Society for Diseases of Esophagus. Guidelines for the clinical and pathological studies on carcinoma of the esophagus. Kanehara, Tokyo 1992.
Haffejee AA, Angorn IB. Nutritional status and the nonspecific cellular and humoral immune response in esophageal carcinoma.Ann Surg 1879;189:475–9.
Lozac’h P, Corbeau P, Zabbe C, Charles JF, Youinou P. Peripheral blood and tumor-infiltrating mononuclear cell analysis in esophagus and head and neck cancer.Med Oncol Tumor Pharmachother 1987;4:7–10.
Tsutsui S, Sonoda K, Sumiyoshi K, et al. Prognostic significance of immunological parameters in patients with esophageal cancer.Hepatogastroenterol 1996;43:501–9.
Herberman RB, Ortaldo JR. Natural killer cells: their role in defense against disease.Science 1981;214:24–30.
Minato N, Bloom BR, Jones C, Holland J, Reid LM. Mechanism of rejection of virus persistently infected tumor cells by athymic mice.J Exp Med 1979;149:1117–33.
Riddle PR, Berenbaum MC. Post-operative depression of the lymphocyte response to phytohaemagglutinin.Lancet 1967;1:746–8.
Park SK, Brody JI, Wallace HA, Blakemore WS. Immunosuppressive effect of surgery.Lancet 1971;1:53–5.
Miller GC, Pritchard DJ, Ritts RE, Ivins JC, Pierre RV. Effect of surgery on quantity of lymphocyte subpopulations.J Surg Res 1976;21:155–8.
Hansbrough JF, Bender EM, Zapata-Sirvent R, Anderson J. Altered helper and suppressor lymphocyte populations in surgical patients.Am J Surg 1984;148:303–7.
Yoshihara H, Tanaka N, Orita K. Suppression of natural killer cell activity by surgical stress in cancer patients and underlying mechanisms.Acta Med Okayama 1986;40:113–9.
Roth JA, Golub SH, Grimm EA, Eiber FR, Morton DL. Effect of operation on immune response in cancer patients. Sequential evaluation of in vitro lymphocyte function.Surgery 1976;79:46–51.
Tsutsui S, Morita M, Kuwano H, et al. Influence of preoperative treatment and surgical operation on immune function of patients with esophageal carcinoma.J Surg Oncol 1992;49:176–81.
Gupta S, Good RA. Subpopulations of human T-lymphocytes: II. Effect of thymopoietin, corticosteroids and irradiation.Cell Immunol 1977;34:10–18.
Petrini B, Wasserman J, Biberfeld J, Baral E, Blomgren H. The effect of in vitro irradation on PHA-mediated cytotoxicity and lymphocytes with receptors for the Fc part of Ig.J Clin Lab Immunol 1979;2:333–6.
Schulof RS, Chorba TL, Cleary PA, Palaszynski SR, Alabaster O, Goldsteim AL. T-cell abnormalities after mediastinal irradiation for lung cancer. The in vitro influence of synthetic thymosin alpha-1.Cancer 1985;55:974–83.
Mandeville R, Sidrac-Ghali S, Ajdukovic I, Vidal D, Ayoub J. Early inhibition of natural and interferon-activated killers in endometrial cancer patients treated with local radiotherapy.Cancer Detect Prevent 1987;10:129–39.
Lennard TW, Shenton BK, Borzotta A, et al. The influence of surgical operations on components of the human immune system.Br J Surg 1985;72:771–6.
Lundy J, Lovett EJ, Hamilton S, Conran P. Immune impairment and metastatic tumor growth.Cancer 1979;43:945–51.
Talmage JE, Meyers KM, Prieur DJ, Starkey JR. Role of NK cells in tumor growth and metastasis in beige mice.Nature 1980;284:622–4.
Hanna N, Fidler IJ. Role of natural killer cells in the destruction of circulating tumor emboli.J Natl Cancer Inst 1980;65:801–9.
Wang BS, Heacock EH, Wu AVO, Mannick JA. Generation of suppressor cells in mice after surgical trauma.J Clin Invest 1980;66:200–9.
Meakins JL, Pietsch JB, Christou NV, et al. Predicting surgical infection before the operation.World J Surg 1980;4:439–50.
Advani SH, Kutty PM, Gopal R, et al. Immunity in esophageal carcinoma.J Surg Oncol 1983;24:268–73.
Saito T, Shimoda K, Kinoshita T, et al. Prediction of operative mortality based on host defense sysytems in patients with esophageal cancer.J Surg Oncol 1993;52:1–8.
Christou NV, Meakins JL, Gotto D, MacLean LD. Influence of gastrointestinal bleeding on host defence and susceptibility to infection.Surg Forum 1979;30:46–52.
Tartter PI. Blood transfusion and infectious complications following colorectal cancer surgery.Br J Surg 1988;75:789–92.
Burrow L, Tartter P. Effect of blood transfusions on clonic malignancy recurrence rate.Lancet 1982;2:662.
Foster RS, Costanza MC, Foster JC, Wanner MC, Foster CB. Adverse relationship between blood transfusions and survival after colectomy for colon cancer.Cancer 1985;55:1195–1201.
Blumberg N, Agarwal MM, Chuang C. Relation between recurrence of cancer of the colon and blood transfusion.BMJ 1985;290:1037–39.
Parrott NR, Lennard TWJ, Taylor RMR, Proud G, Shenton BK, Johnston IDA. Effect of perioperative blood transfusion on recurrence of colorectal cancer.Br J Surg 1986;73:970–3.
Francis DMA, Judson RT. Blood transfusion and recurrence of cancer of the colon and rectum.Br J Surg 1987;74:26–30.
Kaplan J, Sarnaik S, Gitlin J, Lusher J. Diminished helper/suppressor lymphocyte ratios and natural killer cell activity in recipients of repeated blood transfusions.Blood 1984;64:308–10.
Waymack JP, Gallon L, Barcelli U, Trocki O, Alexander W. Effect of blood transfusion on immune function. III. Alternations in macrophage arachidonic acid metabolism.Arch Surg 1987;122:56–60.
Waymack JP, Rapien J, Garnett D, Tweddell JS, Alexander W. Effect of transfusion on immune function in a traumatized animal model.Arch Surg 1986;121:50–5.
Fernandez LA, MacSween JM, You CK, Gorelick M. Immunologic changes after blood transfusion in patients undergoing vascular surgery.Am J Surg 1992;163:263–9.
Cosimi AB, Brunstetter FH, Kemmerer WT, Miller BN. Cellullar immune competence of breast cancer patients receiving radiotherapy.Arch Surg 1973;107:531–5.
Nordman E, Toivanen A. Effects of irradiation on the immune function in patients with mammary, pulmonary or head and neck carcinoma.Acta Radiol Oncol 1978;17:3–9.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mafune, Ki., Tanaka, Y. Influence of multimodality therapy on the cellular immunity of patients with esophageal cancer. Ann Surg Oncol 7, 609–616 (2000). https://doi.org/10.1007/BF02725341
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02725341