Abstract

BackgroundThe association between natural killer (NK) cells and survival in colorectal cancer (CRC) patients remains controversial. This study aimed to clarify the prognostic value of peripheral blood NK cells in CRC patients.MethodsA total of 447 CRC patients who underwent radical surgery and chemotherapy were retrospectively analyzed. Cox regression analyses were used to identify independent prognostic indicators. Correlation between NK cell percentage and other clinicopathological features (gender, age, histological grade, tumor stage, immune cells, and inflammatory indicators) was analyzed. The prognostic values of the combinations of NK cell percentage and other clinicopathological features were also determined.ResultsMultivariate Cox regression analysis revealed that NK cell percentage in the peripheral blood was an independent prognostic indicator in CRC patients. A higher percentage of NK cells indicated a longer survival time than a lower percentage. NK cell percentage was positively correlated to the T and B lymphocyte counts and negatively correlated to the patients’ age and albumin levels. With an area of 0.741 under a receiver operating characteristic curve, NK cells have a moderate predictive value for 3rd-year survival in CRC. This area increased to 0.851 by combining NK cell percentage with the B lymphocyte count. Elderly patients and those at an advanced clinical stage presented a lower percentage of NK cells than younger patients and those at an early clinical stage.ConclusionsThis study demonstrated that NK cells in the blood were an independent predictor of survival in CRC patients, and the combined count of NK cells and B lymphocytes could increase the prognostic value.

Highlights

  • The association between natural killer (NK) cells and survival in colorectal cancer (CRC) patients remains controversial

  • Clinical characteristics of the study objects A total of 447 CRC patients who underwent surgery and chemotherapy were selected after applying the inclusion and exclusion criteria

  • Survival analysis and prognostic value of NK cells in CRC patients Using the median percentage value of NK cells, we found that patients with a lower percentage of NK cells had shorter survival times than those with a higher percentage

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Summary

Introduction

The association between natural killer (NK) cells and survival in colorectal cancer (CRC) patients remains controversial. Surgery and chemotherapy are the major treatment approaches for CRC; their effect is unsatisfactory in patients with distant metastases. This poor effect can be attributed to a suppressed immune system that lacks an effective anti-tumor activity [3, 4]. The T lymphocytes, B lymphocytes, and natural killer (NK) cells form a vital component of the host antitumor immune response.

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