Microinvasive Nd:YAG laser therapy of early glottic carcinoma and its effect on soluble interleukin-2 receptor, interleukin-2, and natural killer cells.

ABSTRACT

OBJECTIVE: To investigate the effectiveness of microinvasive NdYAG laser therapy in human glottic Tis and T1 carcinomas, as well as its effect on the cellular immune function of the tumor-bearing hosts. STUDY DESIGN: We treated 34 patients with microinvasive NdYAG laser therapy and evaluated its effect on the cellular immune function of the host. METHODS: Thirty-four patients with glottic Tis or T1 squamous cell carcinoma were treated with fiberoptic laryngoscopic NdYAG laser surgery. Both before and after therapy, serum levels of soluble interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as natural killer (NK) cell activity, were determined by means of double-antibody sandwich technique, tritiated thymidine-deoxyribonucleoside incorporation, and iodine 125-uridine-deoxyribonucleoside release technique, respectively. RESULTS: All 34 patients tolerated the procedure well. A 3- to 7-year follow-up in a subgroup of 27 patients resulted in an estimated cure rate of 85.2% (23 of 27 patients). In all 27 patients with a regular follow-up, a subjective improvement of phonation was noted after therapy to various degrees. In 74% (20 of 27 patients), voice and speech subjectively recovered to almost normal levels. The post-therapy serum levels of SIL-2R were significantly declined (P <.001), whereas those of IL-2 and the NK activity were significantly elevated (P <.001) as compared with those detected before therapy. CONCLUSIONS: Therapy with fiberoptic laryngoscopic NdYAG laser surgery is simple, safe, effective and only minimally invasive for patients with glottic Tis or T1 carcinoma. At the same time, it has an immunoenhancing effect on its host.