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Cell‐mediated immune status of colon cancer patients. Evaluation by dermal antigen testing, measurement of lymphocyte stimulation and counts of peripheral blood rosette‐forming cells
Author(s) -
Evans James T.,
Goldrosen Martin H.,
Han Tin,
Minowada Jun,
Howell John,
Mittelman Arnold,
Chu T. Ming,
Holyoke E. Douglas
Publication year - 1977
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197711)40:5+<2716::aid-cncr2820400946>3.0.co;2-p
Subject(s) - medicine , immune system , peripheral blood , antigen , stimulation , rosette (schizont appearance) , immunology , immune status , peripheral , lymphocyte , colorectal cancer , rosette formation , cancer , antibody
For 3 years, patients with colorectal cancer admitted to Roswell Park Memorial Institute for curative or exploratory surgery have undergone careful clinical staging of their disease as well as close postsurgical follow‐up as a means to provide accurate clinical information as to extent and course of disease. As a further means of staging, the patients′ carcinoembryonic antigen levels have been measured prior to surgery. In addition, serial plasma CEA measurements have been made to determine how effective this parameter is as a monitor of clinical course in a prospective study of these patients. Furthermore, sequential measurement of a battery of additional host immune status assays has been completed. These assays include: T‐cell number and percent in peripheral blood, B‐cell number and percent in peripheral blood and white blood cell count and differential. Testing dermal antigen response for de novo ability to develop a delayed hypersensitivity reaction with DNCB and testing for recall ability with a standard battery of antigens, mumps, monilia, PPD and SKSD has also been carried out. In addition, we have studied blastogenic response of peripheral blood lymphocytes following incubation in vitro with these same four recall antigens as well as three mitogens, Phytohemagglutinin, Concanavalin A, and Pokeweed Mitogen. This report analyzes the accumulated data on over 100 patients with colorectal cancer with a view to examining the relationship, if any, between disease extent and each immune parameter. Those patients in this group undergoing curative surgery have also been studied to attempt to relate Dukes' classification and carcinoembryonic antigen levels and DNCB sensitization to survival. The other parameters studied have been analyzed to date for our B 2 and C 2 patients only against recurrence. We have found, as we expected, that Dukes' classification is predictive of survival and we have confirmed that this is also true for pretherapy CEA. Although with longer followup, this effect is diminishing, it is still significant at this point. For our patients with B 2 and C 2 disease, we do not have enough follow‐up to test against survival, but against recurrence, it appears that the B 2 and C 2 patients who, prior to definitive surgery, demonstrate a positive monilia test and DNCB irritant response, a lower EAC rosette test count for B cell fraction and a normal CEA are probably safer from recurrence than those who illustrate any of the converse. We are not yet able to make a statement as to how this type of analysis weighs against detailed tumor extent and node analysis of the pathological state of disease at initial treatment, nor are we yet able to say that all four or indeed any combination is more useful than any one. One reason for this is that in our.