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Clinical utility of a novel natural killer cell activity assay for diagnosing non-small cell lung cancer: a prospective pilot study

Authors Choi SI, Lee SH, Park JY, Kim KA, Lee EJ, Lee SY, In KH

Received 13 November 2018

Accepted for publication 1 February 2019

Published 27 February 2019 Volume 2019:12 Pages 1661—1669


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Geoffrey Pietersz

Sue In Choi,1,* Seung Hyeun Lee,2,* Ji-Young Park,3 Kyoung-Ah Kim,3 Eun Joo Lee,1 Sang Yeub Lee,1 Kwang Ho In1

1Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; 2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea; 3Department of Clinical Pharmacology and Toxicology, Korea University College of Medicine, Seoul, South Korea

*These authors contributed equally to this work

Purpose: Although decreased natural killer cell activity (NKA) has been observed in many solid cancers, clinical implication of NKA has been scarcely investigated in lung cancer. The objective of this study was to evaluate the potential of using NKA to support diagnosis of non-small cell lung cancer (NSCLC).
Materials and methods: We prospectively evaluated and compared peripheral blood NKA using a novel interferon-gamma releasing assay in healthy population (n=40), patients with benign lung disease (n=40), and those with NSCLC (n=71). We explored the correlation between NKA and clinical parameters and assessed diagnostic performance of NKA for NSCLC using receiver operating characteristic curve analysis.
Results: Median NKA values in healthy population, patients with benign lung disease, and those with NSCLC were 1,364.2, 1,438.2, and 406.3 pg/mL, respectively. NKA in NSCLC patients was significantly lower than that in the other two control groups (both P<0.001). At a cutoff value of NKA at 391.0 pg/mL, the area under the curve was 0.762 (95% CI: 0.685–0.838, P<0.001), with a sensitivity of 52.3%, a specificity of 91.0%, a positive predictive value of 85.3%, and a negative predictive value of 65.4% for the diagnosis of NSCLC. Multivariate analysis demonstrated that diagnosis of NSCLC is the only clinical parameter that was significantly associated with NKA (P<0.001).
Conclusion: This pilot study showed that patients with low NKA were more likely to have lung cancer. Further studies are warranted in order to establish the clinical utility of NKA test for diagnosing lung cancer.

Keywords: lung cancer, natural killer cell, interferon-gamma, diagnosis, ELISA

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