Influence of multimodality therapy on the cellular immunity of patients with esophageal cancer

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.