Effects Of MICA Expression On The Prognosis Of Advanced Non-small Cell Lung Cancer And The Efficacy Of CIK Therapy

Objective: To investigate the clinical significance of the expression of theNKG2D ligand MHC class I chain-related gene A (MICA) in patients withadvanced non-small cell lung cancer and explore the relationship betweenMICA expression and the efficacy of cytokine-induced killer cell (CIK) therapyfor treating advanced non-small cell lung cancer.Methods: We obtained data on222patients with advanced non-small cell lungcancer (stage III-IV), including data on MICA expression, age, gender, ECOGscore, pathological type, stage, treatment history (including38patients whowere given autologous CIK cell infusion), and overall survival (OS). MICAexpression in lung cancer tissue was evaluated by immunohistochemicalstaining. Analyses of MICA expression, and CIK therapy associations withsurvival outcomes were performed using Cox proportional models,Kaplan-Meier methods, and the log-rank test.Results: MICA was expressed in both membrane and cytoplasm. MICAexpression correlated with the stage of lung cancer, ECOG score, gender andage, while there was no significant correlation between MICA expression andpathological type. The1-year and2-year survival rates of the222patientswere52.3%and19.8%, respectively. Multivariate COX regression analysisshowed that high expression of MICA was an independent prognosis factor ofadvanced non-small cell lung cancer (p=0.002). In subgroup analysis, wedivided the222patients into CIK and control groups. In the CIK group, themedium OS (mOS) of patients with a high expression of MICA was longer thanin those with low expression of MICA (27months vs.13months). In the controlgroup, the mOS in patients with a high expression of MICA was shorter than in patients with low MICA expression (9months vs.18months). COX regressionanalysis showed that the MICA expression affects the effect of CIK therapy(p<0.0001).Conclusion:1) The high expression of MICA is one of the indicators of a poorprognosis for advanced non-small cell lung cancer patients.2) The highexpression of MICA might be one of the predictive factors for successful CIKtherapy.