OBJECTIVETo study the relationship between zeta chain level of peripheral blood T/NK cells and tumor progression in renal-cell carcinoma and bladder cancer and its clinical significance.

METHODSThe peripheral blood mononuclcear cells in 58 patients with renal cell carcinoma, 22 patients with bladder cancer and 14 healthy blood donors were examined by flow cytometry with fluorescent anti-CD3 (for T cells), or anti-CD56 (for NK cells) and anti-zeta chain monoclonal antibodies.

RESULTSThe zeta chain expression of T cell and NK cell in stage I, II and III renal-cell carcinoma decreased to 59.5%, 37.6%, 21.3% and 62.2%, 27.1%, 18.8% of the healthy control level, respectively. That in stage I, II and III bladder cancer decreased to 37.6%, 29.5%, 18.9% and 35.4%, 20.8%, 5.8% of the control level, respectively. T and NK cell zeta chain levels in 17.5% (14/80) of the patients were within the normal range. T/NK ratios of peripheral blood in stage III patients were remarkably lower than those of the healthy donor.

CONCLUSIONReduced T and NK zeta chain levels and T/NK ratio in the renal-cell carcinoma and bladder cancer are generally consistent with tumor progression. The patients with normal T and NK zeta chain level may be indicated for immunotherapy.

Carcinoma, Renal Cell ; immunology ; therapy ; Flow Cytometry ; Humans ; Immunotherapy ; Kidney Neoplasms ; immunology ; therapy ; Killer Cells, Natural ; immunology ; Membrane Proteins ; blood ; Middle Aged ; Receptors, Antigen, T-Cell ; blood ; T-Lymphocytes ; immunology ; Urinary Bladder Neoplasms ; immunology ; therapy

The aims of this study were to analyze lymphocyte and eosinophil counts in consecutive peripheral blood samples taken during immunotherapy for metastatic renal cell carcinoma (mRCC) and to correlate the findings with objective response and survival. A total of 40 patients with mRCC who received immunotherapy with interleukin-2, interferon-alpha, and 5-fluorouracil were analyzed. Objective responses were observed in 14 patients, including 2 (5%) who showed a complete response (CR) and 12 (30%) who showed a partial response (PR). Eleven patients (27%) achieved stable disease (SD), and 15 patients (38%) had progressive disease (PD). Changes from baseline in the total lymphocyte counts were significantly higher in the responding patients (CR+PR+SD) than in the non-responding patients (PD) (p=0.017), but no difference was seen in the total eosinophil counts (p=0.275). Univariate analysis identified the Eastern Cooperative Oncology Group (ECOG) performance status (p=0.017), the presence of a primary renal tumor (p<0.001) and the peripheral lymphocyte counts at week 4 (p=0.034) as prognostic factors, but a low ECOG performance status (p=0.003) and the presence of a primary renal tumor (p=0.001) were identified as independent poor prognostic factors by multivariate analysis. This study provides further evidence that changes in blood lymphocyte counts may serve as an objective indicator of objective responses.
Adult ; Aged ; Carcinoma, Renal Cell/blood/*immunology/secondary/*therapy ; Eosinophils ; Female ; Fluorouracil/administration & dosage ; Humans ; *Immunotherapy ; Interferon Type I, Recombinant/administration & dosage ; Interleukin-2/administration & dosage ; Kidney Neoplasms/blood/*immunology/*therapy ; Leukocyte Count ; *Lymphocyte Count ; Male ; Middle Aged ; Prognosis ; Survival Rate