NK-Cell Count and Its Function in Producing Interferon Gamma Associated with the Cervical Cancer Natural History

Objective: Natural killer cell (NK-cell) has an important role in tumor immunosurveilance. We investigate the NKcell count and its function in producing IFN-γ on normal cervix, subclinical high risk-HPV (hr-HPV) infection, precancerous lesion of cervix, and cervical cancer in order to understand the natural history of uterine cervical cancer. Methods: This is a descriptive comparative numerical study with more than two unpaired group with total subjects of 40 females who met the inclusion and exclusion criteria. Samples were gathered from cervical tissue using cytobrush and were processed in the laboratory to calculate NK-cell count and NK-cell expression of IFN-γ by phyta hemagglutinin (PHA) stimulation using flow cytometry. Data was analyzed using Kruskal Wallis and post hoc analysis was done to determine the difference between groups. Results: The mean NK-cell count on normal cervix, subclinical hr-HPV infection, precancerous lesion, and cervical cancer were 2.6%, 11.6%, 12%, and 7.4%. The mean NK-cell producing IFN-γ on normal cervix, subclinical hr-HPV infection, precancerous lesion, and cervical cancer were 8.1%, 3.3%, 1.1%, and 1.8%. There is significant difference of NK-cell count between 4 groups (p=0.001) but there is no significant difference of NK-cell producing IFN-γ (p=0.577). Conclusion: NK-cell count on normal cervix was significantly lower than other group but it has highest expression of IFN-γ after stimulation. On the other hand, precancerous lesion and cervical cancer has lower expression of IFN-γ after stimulation. Eventhough statistically there is no NK-cell activity difference, this study shows that NK-cell activity in disease groups were impaired. Further study is needed to understand NK-cell activity and its role in cervical cancer natural history. Nowdays, NK-cells as immunotherapy are potential tools for cancer therapy. In the future, we hope that NK-cell activity can be a parameter of cervical cancer progression and strategy to treat cervical cancer.