Immunological variations in women suffering from ovarian cancer. Influence of radical surgical treatment.
BACKGROUND
The immune system includes all the innate or acquired mechanisms, that the organism uses for protecting itself from the aggression of external pathogens or neoplasia. About the control of the tumor growth, the immune mechanisms implicated are quite a lot: the cytotoxicity against the tumor cells by cytotoxic T lymphocyte, macrophages, NK cells; simil-NK cells (ADCC). Tumors have generally antigenic marked potential, for which numerous antigens have been identified, but none of these has revealed a correlated specificity to the neoplasia. Only a glycoprotein at elevated molecular weight, the CA125, presents an elevated specificity and sensibility. The objective of this study was to examine immunological variations in the peripheral blood of patients with ovarian carcinoma before and after radical surgical treatment.


METHODS
In the Institute of Obstetrics and Gynaecology of Second University of Studies of Naples the immunological variations in 8 women (mean age: 59.5; range: 49-70 years) suffering from ovarian cancer, have been evaluated before and after radical surgical treatment (when the stage of the tumor made possible the surgery) and compared to 8 normal volunteers of comparable age (control group), in the period January 1994-June 1998. The patients were followed in average for two years and subjected to a immunological screening with blood drawings effected at the hospitalisation and later 1, 6, 12, 18, 24 months from surgical treatment. The immune evaluation were effected with: proliferation tests on the monocytes of the peripheral blood, evaluation of the production of Interleukin 1 and 2 with the leukocyte phenotyping, evaluation of NK cells activity. The patients were followed in average for two years.


RESULTS
The radical surgery decidedly improves the immune response. The ability to produce IL-1 by the lymphocytes of the patients object of our study, appeared constantly falling (with reduction of about 50%) before the surgery and it meaningfully increases in the post-surgery period. The surgery doesn't modify the lymphocytes T helper and T inducer. The surgery delays the diminution of the NK cells in a little meaningful way. The periodic dosage of the CA125 does not give the same results: in the 60% a progressive increase was realised and in the 40% it remained constant.


CONCLUSIONS
The surgery constantly improved the physical state of the patient, determining an increase of the immune response toward the neoplasia, and therefore achieving a meaningful increase of survival.
Rampone
B
B
Institute of Obstetrics and Gynaecology, Second University of Naples, Italy.
Rampone
A
A
Tirabasso
S
S
Panariello
S
S
Rampone
N
N
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D007694:Killer Cells, Natural / Q000276:immunology; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D010051:Ovarian Neoplasms / Q000097:blood / Q000276:immunology* / Q000601:surgery*
D007375:Interleukin-1; D007376:Interleukin-2