Natural killer cell activity in patients with adenocarcinoma in the upper gastrointestinal tract.

Natural killer (NK) cell activity and the in vitro effect of recombinant gamma interferon (r gamma-IFN) were evaluated in 12 patients with esophageal adenocarcinoma, 14 patients with gastric adenocarcinoma, 12 patients with pancreatic adenocarcinoma, and 19 healthy controls against the erythroleukemia cell line K-562. Patients with upper gastrointestinal tract carcinomas had a similar spontaneous NK cell activity as the control group. After stimulation with r gamma-IFN, however, the NK cell activity of patients with esophageal or pancreatic adenocarcinoma was significantly lower than that of patients with gastric carcinoma and that of the controls (p less than 0.05). When all patients with adenocarcinomas were classified according to the advancement of the disease, a marked impairment of NK cell activity was found in patients with advanced disease (p less than 0.01) compared to the patients with localized disease or to the controls. Although r gamma-IFN stimulated the NK cell activity of both patients and controls significantly, 62% of the patients with carcinoma and advanced disease remained below the normal spontaneous NK cell activity level even after r gamma-IFN stimulation. In conclusion, an impaired NK cell activity was found in patients with esophageal or pancreatic cancer. Patients with advanced disease were more likely to have an impaired NK cell activity than those with localized disease. The decreased NK cell activity, in particular of patients with esophageal or pancreatic carcinoma, may be related to the unfavourable prognosis of these patients.