Lymphopenia and deranged lymphocyte subsets in nasopharyngeal carcinoma

The peripheral blood lymphocyte counts of 333 patients with a nasopharyngeal carcinoma and 125 control subjects were compared. The mean pretreatment lymphocyte count in the patients was significantly lower than that of the normal controls (P less than 0.0001). Subgroup analysis of absolute lymphocyte counts in different stages of the disease revealed a stage dependent lymphopenia which became significant when the disease was stage III or over (P less than 0.001). Characterization of peripheral blood lymphocyte subsets in 81 patients and 46 normal control subjects revealed a significant reduction of the absolute Pan T (T11) lymphocytes in the patients (P less than 0.0001). Both the absolute numbers of T helper (T4) and suppressor cells (T8) were reduced in the patients (P less than 0.0001 and less than 0.026, respectively). While the percentage of T4 was reduced (P less than 0.0001), the percentage of T8 was elevated (P less than 0.02), resulting in a reduced T4/T8 ratio (P less than 0.0001). The mean absolute and percentage counts of T11, T8 and B did not correlate with different stages of the disease.     

Alterations in T-lymphocyte subpopulations in patients with head and neck cancer. Correlations with prognosis

Impaired cell-mediated immunity has been consistently demonstrated in patients with advanced head and neck squamous cancer (HNSC); however, the results of prior studies of correlations of cellular immune parameters with treatment outcome have been inconsistent, and routine assessment of immune parameters has been of limited clinical use. To determine the prognostic importance of alterations in the proportions of various T-lymphocyte subpopulations in the peripheral blood of patients with HNSC, levels of T3, T4, T6, T8, T9, T10, T11, and Leu 7 cells were quantitated by flow cytometry in 80 previously untreated patients and prospectively correlated with tumor characteristics and clinical course (median length of follow-up, 27 months). The mean helper/suppressor cell ratio (T4/T8) increased progressively with increasing tumor stage and was significantly elevated among patients with cancer as a group and in patients with advanced (stage III or IV) disease compared with 40 normal subjects. Decreased disease-free survival was significantly associated with elevated T4/T8 ratios and low percent T8 and T11 cell levels. The prognostic significance of percent T8 (cytotoxic/suppressor) cell levels persisted even after adjusting for known prognostic factors of tumor stage, T class, N class, and tumor site. These correlations provide new insight into immune alterations in HNSC that may prove useful in identifying patients with early clinical disease who have a poor prognosis.     

THE RELATIONSHIP OF CIRCULATING IgA TO CELLULAR IMMUNITY IN HEAD AND NECK CANCER PATIENTS

The relationship of circulating IgA titers and multiple parameters of cell-mediated immunity was examined in 97 patients with head and neck cancer. In 26% of the patients, IgA titers were above one standard deviation of controls, with highest levels noted in patients with advanced disease. In 40 patients for whom multiple immune parameters were tested in vitro, increasing concentrations of IgA were associated with an enhanced immunologic helper state defined by a generalized hypergammaglobulinemia, increased percentage of T4+ lymphocytes, higher T4/T8 ratio, and an increased lymphocyte blastogenesis response to mitogens. IgA concentrations were inversely related to percentages and absolute number of Leu 11+ natural killer cell subsets, and also to disease-free survival (p < 0.005 by Cox proportional hazards model). The immune correlations identified here are similar to those noted in many autoimmune diseases. Head and neck cancer patients are an immunologically heterogeneous population, among whom elevated IgA blood levels may reflect the autoimmune nature of cancer, an immunologic state defined by its tumor-promoting capacity.     

Double immunoenzymatic and two-color flow cytometric analyses of tonsillar T-cell subsets]

Distribution of various T-cell subsets in the palatine tonsil was investigated by two-color flow cytometry and double immunoenzymatic stain. Tonsillar lymphocytes contained many (about 20%) helper T (CD4+ Leu8-) cells and few (only 1%) suppressor T (CD8+ CD11b+) cells. In interfollicular area, each T-cell subset, i.e., helper, helper-inducer (CD4+ CD29+), suppressor-inducer (CD4+ CD45RA+), cytotoxic (CD8+ CD11b-), and suppressor, was identified by double immunoenzymatic labeling technique using alkaline phosphatase and peroxidase. On the other hand, only two T-cell subsets, helper, and cytotoxic T-cell subpopulations, were recognized in germial center. These results indicate that double immunoenzymatic stain as well as two-color flow cytometry gives us useful informations in terms of tonsillar T-cell subsets.     

Distribution of circulating natural killer cells and T lymphocytes in head and neck squamous cell carcinoma

Objective

Natural killer (NK) cells are capable of eliminating malignantly transformed cells without prior sensitization. In contrast to NK-cells, T lymphocytes possess antitumourous activity that is restricted to major histocompatibility complex (MHC) recognition. The aim of this study was to determine the causes of the different distributions of these cell types in the peripheral blood of patients with head and neck squamous cell carcinomas (HNSCC).

Methods

A cohort of 105 subjects was divided into three clinical groups: non-treated HNSCC patients, treated relapse-free HNSCC patients and healthy control subjects. Peripheral blood mononuclear cells (PBMC) were isolated from venous blood, subsets were depleted, flow cytometric counts were made and subsequently correlation analyses with clinical parameters were performed.

Results

Treated relapse-free HNSCC patients have a significantly increased mean proportion of NK-cells in PBMC of 26.39% (p < 0.001), whereas T lymphocytes and natural killer-T-(NKT) cells of treated patients have a significantly decreased mean proportion in PBMC of 55.15% (p < 0.05) at least 12 months after treatment. This inverse redistribution of these two subsets is reflected in a significantly increased mean NK/T-ratio of 0.54 (p < 0.05) in treated patients. The NK/T-ratio correlates with the systemic invasiveness of the type of therapy patients undergo and is highest after surgery with adjuvant radiochemotherapy (0.64, r_s = 0.334, p < 0.01). This appears to be a post-therapeutic long-term effect in treated patients, as they had a mean relapse-free period until venous puncture of 47.9 months in our study. We also demonstrated age-dependent changes in the peripheral distribution of T- and NK-cells.

Conclusion

These findings reveal new aspects in understanding tumour biology and interactions with the cellular immune system which provide novel starting points for further research.     

Postirradiation sinus mucosa disease in nasopharyngeal carcinoma patients

OBJECTIVES/HYPOTHESIS: We sought to determine the incidence, progression, and risk factors for postirradiation sinus mucosa diseases (SMD) incidentally found on follow-up magnetic resonance images MRIs) in nasopharyngeal carcinoma (NPC) patients.STUDY DESIGN: RETROSPECTIVE. METHODS: The medical records, pre- and postradiotherapy (RT) MRIs were reviewed in NPC patients. Lund-Mackay system for staging of rhinosinusitis (Lund score) was used as a tool for investigation. RESULTS: One hundred twelve NPC patients (77 males and 35 females) were recruited in this study. The distribution of tumor staging in these patients were 39 (34.8%) patients in T1,23(20.5%) in T2, 31(27.7%) in T3, and 19 (17.0%) in T4 by MRI staging before RT. In these 62 patients with normal sinus ventilation before RT, 42 (67.7%) patients returned to having SMDs 3 months after RT. The maxillary,anterior ethmoid, and posterior ethmoid sinuses were most readily affected. In patients with SMDs at 3 months postRT, advanced tumor stage (P = .013) and smoking habit (P =.047) were the two factors that significantly influence Lund score. When comparing Lund score with different times after radiation therapy, a trend of decrease in Lund score could be noted from 3 months to 3 years after irradiation.CONCLUSIONS: The incidence and severity of SMD was found to be highest at 3 months postRT and decreased gradually with time. Conservative management with clinical symptom correlation should be attempted first in these patients. In these NPC patients,advanced tumor stage and smoking habit would predispose them to SMD development.     

阻塞性睡眠呼吸暂停低通气综合征患儿手术前后淋巴细胞亚群分析

目的 检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿手术前、后外周血淋巴细胞亚群的比例,研究手术前及手术后3～6个月患儿淋巴细胞亚群比例的改变情况.方法 随机选择30例OSAHS患儿,采集外周静脉血进行淋巴细胞亚群检测,所有患儿均住院在全麻下接受扁桃体联合腺样体等离子切除手术,术后3～6个月进行复查.选取30例年...     

Suppression of the Th2 pathway by suplatast tosilate in patients with perennial nasal allergies

BACKGROUND: Suplatast tosilate (IPD-1151T), a selective Th2 cytokine inhibitor that suppresses the production of interleukin (IL)-4 and IL-5 in vitro or in animal models has been proved clinically effective for allergic rhinitis (AR). The aim of this study was to investigate changes in the Th2 pathway in human nasal mucosa after medication with IPD-1151T. Twelve patients were treated with IPD-1151T. METHODS: Twelve healthy volunteers served as normal controls. The following parameters were evaluated: (i) subjective nasal clinical symptoms, (ii) percentages of inflammatory cells (EG2, CD4, and CD8) by immunocytological staining, and (iii) levels of cytokines (IL-4, IL-5, IL-13, regulated on activation, normal T-cell expressed, and secreted [RANTES], and interferon [IFN] gamma) by enzyme-linked immunosorbent assay. RESULTS: Nasal symptom scores significantly decreased after treatment. With respect to cell infiltration, a significant decrease was observed in the percentage of inflammatory cells (EG2 and CD4) and CD4/CD8 ratio. The levels of cytokines (IL-4, IL-5, IL-13, and IFN-gamma) and the IL-5/IFN-gamma ratio were significantly decreased, and the IL-4/IFN-gamma ratio became not significantly different from that in normal subjects. In contrast, RANTES did not change significantly. The percentage of reduction in IL-5 correlated with that in eosinophil infiltration, whereas that in RANTES did not. CONCLUSION: These results suggest that IPD-1151T can reduce the Th2 pathway.     

慢性扁桃体炎患者外周血T淋巴细胞亚群测定

目的：探讨慢性扁桃体炎患者免疫状态。方法：对６０例慢性扁桃体炎患者进行外周血Ｔ淋巴细胞亚群测定。结果：慢性扁桃体炎患者的ＣＤ４,ＣＤ４／ＣＤ８较正常对照组降低（Ｐ〈０．０１）。结论：慢性扁桃体炎患者细胞免疫功能受抑制,免疫系统失衡。     

消瘤汤治疗鼻内翻性乳头状瘤的疗效及其作用机理研究

目的 观察消瘤汤对鼻内翻性乳头状瘤术后复发与恶变的抑制作用及对宿主细胞免疫功能的影响.方法 鼻内翻性乳头状瘤患者60例,术后随机分为治疗组和对照组,每组各30例.治疗组术后服消瘤汤半年,对照组不用药物治疗,均随访8个月以上,观察病变复发和恶变情况.分别在术前及术后半年,以流式细胞仪检测患者外周血T淋巴细胞亚群及NK细胞活性,观察消瘤汤对宿主细胞免疫功能的影响.结果 治疗组复发2例（2/30,6.7%）,对照组复发8例（8/28,28.6%,其中3例存在轻至中度不典型增生）,差异具有统计学意义（P＜0.05）.与术前检测结果比较,治疗组的CD3^＋、CD4^＋T细胞及NK细胞比例升高,CD8^＋T细胞比例降低,对照组的CD3^＋、CD4^＋T细胞及NK细胞比例均降低,而CD8^＋T细胞比例升高.结论 消瘤汤可降低鼻内翻性乳头状瘤患者的术后复发率,并通过改善宿主细胞免疫功能而起到抑制其复发与恶变的作用.     

Observations on immunologic parameters in laryngeal cancer patients

Patients with laryngeal cancer were examined immunologically before treatment and for 1-10 years after treatment. In the pretreatment group, the percentage of T cells, lymphocyte blastoid reaction (PHA, concanavalin A), and skin reactions (PHA) were generally in the normal range, but absolute numbers of T cells and lymphocytes were reduced in most patients. In the group with no recurrence after surgery, the absolute number of T cells and lymphocytes, IgG X FcR+T cells (T gamma), and skin reactions was normal in many cases. The group with recurrence showed reduced percentage of T cells and an absolute number of T cells and lymphocytes. The absolute number of T cells and lymphocytes and the PPD skin reaction increased after surgery in some cases, but reductions in some of the parameters were noted in a few cases long after surgery. Radiation therapy for patients with tumors at early stages did not significantly change the percentage of T cells or the skin reactions.     

放化疗联合治疗局部晚期鼻咽癌的临床研究

目的：探讨放化疗交替疗治疗局部晚期鼻咽癌的临床疗效。方法：回顾性分析106例局部晚期鼻咽癌患者临床资料。单纯放疗15例;91例接受PF方案为基础的诱导化疗和（或）辅助化疗,其中诱导化疗加放疗加辅助化疗36例,诱导化疗加放疗25例,放疗加辅助化疗30例。诱导化疗1～2周期,辅助化疗3～6周期。放疗于诱导化疗结束后第1天进行,辅助化疗在放疗结束后1周开始进行。鼻咽原发灶采用60Co,常规分割照射68-74Gy,颈部根治量60～70Gy,颈部预防量48～50Gy,每组均完成根治量放疗。结果：中位随访时间51个月,58例患者死亡,全组总生存率为45．3％。单纯放疗、诱导化疗加放疗加辅助化疗、诱导化疗加放疗、放疔加辅助化疗的5年总生存率分别为33％、63％、60％、50％,无瘤生存率分别为13％、56％、48％、40％,无局部复发率分别为13％、53％、48％、50％,无远处转移率分别为6％、50％、44％、47％,均差异有统计学意义（P〈0．05）。各组发生复发、转移的中位时间分别为22、29、28、25个月;10、19、15、12个月,均差异无统计学意义（P〉0．05）。诱导化疗加放疗加辅助化疗组急性毒性反应较其他组重,但未影响治疗进程,患者均可耐受。结论：诱导化疗和辅助化疗联合尽早开始的放疗治疗局部晚期鼻咽癌疗效较好,不良反应轻,适合局部晚期鼻咽癌患者的综合治疗。     

Impaired CD4+CD25+ regulatory T cell activity in the peripheral blood of patients with autoimmune sensorineural hearing loss

CD4⁺CD25⁺ regulatory T cells exert an immune regulatory function and thus play an important role in the control of self-reactivity in the pathogenesis of autoimmune inflammatory conditions. The aim of the study presented here is to perform a quantitative and functional analyses of these cells in patients with autoimmune sensorineural hearing loss (ASNHL). T cell subsets (CD4⁺CD25⁺, CD4⁺CD25^high, CD4⁺, and CD8⁺) from the peripheral blood of 17 patients with ASNHL, 16 patients with noise induced hearing loss (NHL), and 100 normal controls were analyzed by flow cytometry. The CD4/CD8 ratio was also analyzed. In addition, the suppressive capability of CD4⁺CD25⁺ T cells was tested in vitro by measuring their ability to suppress the proliferation and IFN-γ secretion of CD4⁺CD25⁻ T cells. No significant difference was found in the T cell subsets of ASNHL patients compared to normal controls or NHL patients, except that the proportion of CD4⁺ T cells was elevated in ASNHL patients. However, we did observe defective regulatory function of CD4⁺CD25⁺T cells in patients with ASNHL. Our data supported the idea that CD4⁺CD25⁺ regulatory T cells played an immunosuppressive function in the periphery. The impaired suppressive activity of these cells may be an important factor in the pathogenesis of ASNHL.     

淋巴细胞在慢性鼻-鼻窦炎组织中的表达及意义

目的：探讨B淋巴细胞（CD20）和T淋巴细胞亚群（CD4、CD8）在慢性鼻-鼻窦炎（CRs）中的表达及在炎症反应中的作用。方法：采用免疫组织化学技术检测B淋巴细胞（CD20）和辅助性T细胞（CD4）、细胞毒性T细胞（CD8）在实验组[分为15例CRS不伴鼻息肉（CRSsNP）组、12例CRS伴鼻息肉（CRSwNP）组、7例复发性CRSwNP组]和对照组（13例下鼻甲黏膜对照）中的表达。采用Mann-WhitneyU检验分析实验组和对照组B淋巴细胞、T淋巴细胞亚群的表达情况,实验组组间淋巴细胞浸润比较用单因素方差分析One—WayANOVA。结果：与对照组相比,实验组有明届的13淋巴细胞（CD20）和T淋巴细胞亚群（CD4、CD8）浸润（P〈0．05）：T淋巴细胞、亚群（CD4、CD8）在CRSwNP组和复发性CRSwNP组病变中的表达明显高于CRSsNP组（P〈0．05）;CD4在复发性CRSwNP组中的表达明显高于CRSwNP和CRSsNP组（P〈0．01）。结论：实验组鼻腔黏膜中B淋巴细胞、辅助性T细胞和细胞毒性T细胞高表达,均参与炎症的形成,其炎症匣应与T淋巴细胞浸润密切相关。     

Radiation therapy for nasal vestibule squamous cell carcinoma: a 40-year experience

We evaluated the treatment of squamous cell carcinoma (SCC) of the nasal vestibule. Eighty-six patients were treated with radiotherapy (RT) and 13 patients received surgery and RT. The mean follow-up was: 9.7 years (range 4 months–35.9 years). The 5- and 10-year outcomes were: local control (LC), 88 and 82 %; local–regional control (LRC), 78 and 73 %; freedom from distant metastases (FFDM), 96 and 96 %; cause-specific survival (CSS), 91 and 86 %; and overall survival, 75 and 51 %. The 5- and 10-year LC rates for patients treated with RT were 94 and 89 % overall. A multivariate analysis was performed. Tumor size predicted LC, LRC, OS, and CSS. Overall stage predicted LRC. RT cures most patients with T1–T2 and favorable T4 SCCs with acceptable toxicity. RT and surgery result in improved likelihood of cure for patients with advanced T4 lesions.     

Experience in the treatment of 98 carcinomas of the nasopharynx. Long-term follow-up and analysis of prognostic factors

This was a retrospective study of 98 patients (pts.) with histologically confirmed nasopharyngeal carcinoma. The clinico-demographic characteristics were: median age of 53 years (11-83); 74 males and 24 females (ratio 3:1); histology subtype OMS 2-3 in 89 pts. (90.8%); cranial nerve deficits in 11 pts. (11.2%); 50 (51%) were stage T3T4; 68 pts. (69.4%) N2N3 and 77 pts. (78.6%) stage IV. The therapeutic modalities were: radical radiotherapy (RT) alone in 42 pts., chemotherapy (CT) alone in 4 pts., RT + adjuvant CT in 10 pts. and neoadjuvant CT + RT in 42 pts. RT was delivered in wide fields, doses between 50-75 Gy with conventional fractionation. CT consisted in cisplatinum-based schedules (PF in 34 pts., BEC in 9 and others in 13 pts.). Analyzed by treatment, more males and stages N2N3 and IV were accrued in neoCT + RT arm (p < or = 0.05). For the entire population, the overall complete response was achieved in 65 pts. (66.3%); in 27/35 pts. (77.1%) of the RT group and 30/51 pts. (58.8%) of CT + RT group (p 0.07) of pts. with III-IV stages. With a median follow-up of 74.5 months, 32 pts. (32.65%) are alive and free of disease. The projected OS for all pts. was 40 months (m), 51.4% at 3 years (y) and 45.5% at 5 y with a disease free survival of 37 m (0-236). No differences between treatment arms were found (p 0.4). In univariant analysis for OS in stage III-IV pts., age > 50 y, histology OMS1, cranial nerve deficits, stage T3T4 and N2N3, were considered adverse prognostic factors (p < or = 0.05). In multivariant analysis, only age > 50 y and stages T3-T4, N2-N3 were significant (p < or = 0.05). In conclusion, we demonstrated good long term survival without any differences among treatment modalities in pts. with advanced nasopharyngeal carcinomas. New therapeutic approaches are warranted in order to improve the outcome of this patients.     

Carcinoma of the tongue base treated by transoral laser microsurgery, part one: Untreated tumors, a prospective analysis of oncologic and functional outcomes

OBJECTIVES: To report the oncologic and functional outcomes of transoral laser microsurgery (TLM) in the management of untreated primary carcinoma of the tongue base. STUDY DESIGN: A two center prospective case series analysis. METHODS: Fifty-nine patients with pathologically confirmed squamous cell carcinoma of the tongue base were treated with TLM between 1997 and 2005. The pathological T stage distribution was: T1, 16; T2, 23; T3, 12 and T4, 8. Thirty-six patients presented with stage IV disease, 12 with stage III, 7 with stage II and 4 with stage I disease. Neck dissections were performed in 49 patients (83%). Twenty-eight patients (47%) underwent adjuvant radiotherapy. End points analyzed were local control, loco regional control, disease specific survival, and overall survival. Organ function was assessed before and after treatment using a clinical Functional Outcome Swallowing Scale (FOSS) and Communication Scale (CS) staging system. RESULTS: The mean follow up for all patients was 31 months. The 2 and 5-year Kaplan-Meier estimates were: local control, both 90%; loco-regional control, both 88%; recurrence free survival, both 84% and overall survival 91% and 69% respectively. For all patients the median stay in hospital was 4 days. The median length of hospital visit for TLM alone was 2.5 days and 4 days for TLM with neck dissection. Three patients (5%) suffered minor post-operative hemorrhage. The median pre-operative FOSS stage was 0 (normal function.) The median post-operative FOSS stage was stage 1 (Normal function with episodic or daily symptoms of dysphagia.) There were no clinically significant changes in communication function after treatment. CONCLUSIONS: Transoral laser surgery is a safe and effective treatment for select early and advanced previously untreated squamous cell cancer of the tongue base. In addition, the low morbidity and mortality and shortened duration of hospitalization associated with TLM make it an attractive therapeutic alternative.     

Immune Reactivity Does Not Predict Chemotherapy Response,Organ Preservation,or Survival in Advanced Laryngeal Cancer

Objective To determine whether pretreatment lymphocyte subpopulations correlate with tumor response to induction chemotherapy as part of an organ preservation treatment approach in patients with advanced laryngeal cancer. Study Design A prospective clinical trial in patients with advanced laryngeal cancer was undertaken to determine whether the frequency of late salvage laryngectomy and overall survival could be improved using one cycle of neoadjuvant chemotherapy to select patients for organ preservation. Pretreatment peripheral blood lymphocyte subpopulations for CD3, CD4, CD8, NK, and B cells were correlated with tumor response to induction chemotherapy, larynx preservation, and survival, to determine whether immune parameters could be useful in patient selection. Methods The study setting was a tertiary referral academic health center. Studied were 53 patients with stage III (42%) or IV (57%) larynx cancer. Most patients had supraglottic cancers (73%) and positive clinical nodes (51%). Sixty‐eight percent had greater than 50% tumor response after one cycle of induction chemotherapy and then received concurrent chemoradiation and two cycles of adjuvant chemotherapy. Lymphocyte subpopulations were measured in 39 patients. Mean follow‐up was 23.3 months (range, 5–61 mo). Results A total of 18 (34%) patients underwent laryngectomy. Only 4 cases were late salvage resections (13–35 mo after treatment). Fourteen cases were planned surgery after initial chemotherapy. Of the lymphocyte subpopulations measured, CD8 levels were significantly lower in stage IV patients and tended to be lower in patients with successful organ preservation. However, no significant differences in lymphocyte subpopulations were found among responders and nonresponders to chemotherapy. Overall survival was 88%. Conclusions One cycle of neoadjuvant chemotherapy was effective in selecting patients for organ preservation. The regimen of definitive concurrent and adjuvant chemotherapy was associated with an unexpectedly high 2‐year survival rate. Lymphocyte subsets were not significant predictors of responding patients or survival. Further study of other biological markers useful in selecting patients for organ preservation are needed.     

Hypertetraploid cells in vocal cord epithelia

DNA measurements yield information about the nature of cells and may provide diagnostic and prognostic information. Static cytofluorometry was performed on smears removed at microlaryngoscopy from 107 vocal cord lesions (96 patients). All stem cell lines were diploid except 3; 2 carcinomas and 1 severe dysplasia were polyploid. The mean proliferative activity (percentage of nuclei greater than diploid peak) was 2.1% for the group of epithelia with hyperplasia and mild dysplasia, 3.1% for those with moderate dysplasia, 4.0% for severe dysplasia, and 6.8% for carcinomas. Hypertetraploid cell nuclei (HT cells) were not found in epithelia with hyperplasia and mild dysplasia. Seven out of 15 patients with epithelia showing moderate dysplasia had HT cells; 5 of these patients developed a carcinoma. One of 8 without HT cells developed a severe dysplasia. Nine patients with severe dysplasia had HT cells; 4 had recurrences and 4 developed carcinoma within 4 years. In 14 patients without HT cells, 3 had recurrences and 1 developed a carcinoma 6 years later. HT cells were found in 15 patients with T1 & T2 carcinomas; residual carcinoma was present in 2 after radiotherapy and 4 had recurrences within 11 months. Fourteen patients with T1 & T2 carcinoma did not have any HT cells; one had residual carcinoma after radiotherapy and 3 had recurrences between 18 months and 4 years. DNA measurements and, especially, the demonstration of epithelia with HT cells prove to be of prognostic importance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Local infiltration of T-lymphocyte subsets as a prognostic indicator in patients with nasopharyngeal carcinoma

We studied tumor-host interactions in 47 patients with NPC. The local infiltration of T-lymphocyte subsets was investigated by an immunoperoxidase technique using monoclonal antibodies. Biopsy specimens of patients without cervical metastasis showed more T-lymphocyte (T11) infiltration. The amount of Leu-3a (helper/inducer) and T8 (cytotoxic/suppressor) cell infiltration did not correlate with the age, sex, clinical stage, and peripheral blood T4 and T8 cells of the patients. A higher incidence of Leu-3a cell infiltration was found in patients with high serum IgA antibody titers to EBV VCA. A trend of better prognosis was revealed in those cases with no or slight stromal T8 cell infiltration. A local immune response was found to exist which may prevent the spread of NPC to the cervical nodes, but this needs further study to evaluate the local infiltration of T-lymphocyte subsets as a prognostic indicator.