The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 339-350, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Immune reactivity in primary carcinoma of the lung and its relation to prognosis
HJ Wanebo, B Rao, N Miyazawa, N Martini, MP Middleman, HF Oettgen and EJ Beattie Jr
Detailed studies of immune reactivity were performed in 154 patients with
primary lung cancer, 20 patients with benign thoracic lesions, and 109
healthy persons. Reactions to the 2,4-dinitrochlorobenzene (DNCB) skin test
were postive in 73 per cent of patients with lung cancer and all (100 per
cent) of the patients with benign disease (p less than 0.05). The incidence
of DNCB reactions was 78 per cent for Stage I and II cancers (37 patinets),
73 per cent for resectable Stage III cancer (22 patients), and 66 per cent
in patients with unresectable or inoperable Stage III cancer. DNCB
reactivity showed a relationship to primary histology. The incidence of
DNCB positive reactions was 80 per cent in patients with epidermold
carcinoma versus 57 per cent in patients with adenocarcinoma, 64 per cent
in patients with oat cell cancer, and 80 per cent in patients with terminal
bronchiolar carcinoma. In vitro immune studeis correlated best with stage
of disease. These included the absolute lymphocyte count and absolute T
cell count and lymphoxyte stimulation witalen A (Com A). These values were
in the normal range in patients with Stage I cancer but were significantly
depressed in patients with Stage III cancer. Svrvival curves were plotted
in patients with Stage III disease according to the responses to three
immune parameters: DNCB, absolute lymphocyte count, and PHS stimulation.
Although patients with normal reactions generally had better survival
rates, PHA responses showed the most significant correlation to survival.
These tests support the usefulness of immune testing as an additional
parameter of assessing biological risk in patients with primary lung
cancer.
