New City Osaki Clinic homepage > Treatment outcomes and case reports > Hepatoma, case of hepatoma
When chronic hepatitis C progresses to cirrhosis and further to hepatoma, it repeatedly recurs after surgeries such as radiofrequency ablation and resection, and the interval between recurrences is gradually shortened--this is the typical course of progression.
In this patient, hepatoma of about 2 cm in diameter was detected during the observation of the condition of cirrhosis and was surgically resected. After six years, a lesion of about 1.5 cm recurred and was treated with the second surgery. Half a year later, the patient was suspected to have a lesion of about 1 cm, which would be the second recurrence.
This patient was considered to be in “hypercarcinogenic state” and hepatoma was expected to repeatedly recur in the future. At the fervent request of the patient, we decided to treat hepatoma without surgeries or anticancer agents, but only by the highly active NK (natural killer) cell therapy of the New City Osaki Clinic.
In the contrast-enhanced CT image immediately before the treatment (Photo 1: left), the faint white spot in the circled area is cancer.
We can confirm that it nearly disappeared in the CT image obtained three months after the start of the treatment (Photo 1: right).
This patient continued cancer immunotherapy at our clinic after the cancer disappeared. As shown in Figure 1 (data up to 16 months after the treatment are presented), liver function (AST) is gradually normalized and a tumor marker, AFP, which was high even after the surgeries, was rapidly decreased starting at the time of the tenth administration and returned to the normal level.
Getting over the stagnating state of hepatitis and having improved physical condition, the patient came to enjoy normal life.
Thirty months have passed since the treatment was started at our clinic. Liver function and AFP have been maintained at normal levels and there was no recurrence. The frequency of immune cell therapy for cancer was reduced to once in three to four months, but the body’s immunity is maintained at a high level.
This patient did not especially use anything, including nutritional supplements, other than highly active NK cell therapy.
Liver function was normalized and the tumor marker, AFP, was also decreased to the normal level. How did the immunity of the body change during such improvement?
1) Increase in NK cells
Of 15 billion cultured and activated lymphocytes administered to this patient, 30 to 40% were NK cells and the rest consisted of activated T cells. When we examined the changes in the body caused by this administration by collecting blood immediately before the administration and regularly afterwards, the proportion of NK cells in blood was tripled from 8% immediately before the administration to 24% three days later and maintained at the level close to twice as high as the level before the administration both one week and two weeks later (Figure 2).
2) Enhancement of the cancer-attacking molecule, NKG2D
NK cells and some T cells (including CD8-positive T cells and NKT cells), which are called, “killer cells”, have on their surface the molecules called NKG2D which attack cancer cells. In patients with various types of cancer, NKG2D is reduced and the power to attack cancer cells is weakened. It was reported that, in hepatoma, NKG2D on NK cells is decreased and NK cells cannot function well.
We collected the patient’s blood before the cancer immunotherapy was started and six months after the treatment and examined and compared the positive rate of NKG2D in NK cells and T cells. The result is shown in Figure 3.
The positive rate of NKG2D increased from 38% before the treatment to 60% at six months after the treatment. When we look at the details, not only the rate in NK cells, but also the rate in T cells particularly increased. This result indicates that the immunological capacity of both NK cells and T cells which attack hepatoma was enhanced.
Thus, highly active NK cell therapy not only strengthened the NK cells throughout the body, but also increased NKG2D-positive T cells and positive T cells with molecules called CD 56, which play the roles similar to those of NKG2D-positive T cells, thereby greatly influencing the activity of T cells and enhancing the immunity of the entire body.
This patient is currently continuing to receive the administration at an interval of three to four months. Even with such a long interval, high immunity is maintained. The improvement in the immunity of the whole body described above is probably preventing the recurrence of hepatoma for a long period of time.