Delayed hypersensitivity reactions in patients with squamous cell cancer of the head and neck

Sixty-three patients with squamous cell cancer of the head and neck were evaluated, correlating TNM class with delayed hypersensitivity reactions. These cell-mediated immune responses were impaired early in the course of the disease. Eight of twenty-four patients with T₁ or T₂ N₀ lesions were DNCB-negative. With more advanced lesions, reactivity was further impaired. Only one of six patients with T₃ or T₄ N₀ lesions was DNCB-positive. There is an impaired response not only to newly encountered antigens but also to previously encountered antigens.There was a correlation between DNCB reactivity, recurrence, and survival in patients with localized disease. There was also similar correlation of PPD reactivity and survival at the one year level. In the presence of cervical node metastases, there was no apparent difference in recurrence or survival related to DNCB reactivity.Skin test reactivity to DNCB in patients with head and neck cancer has apparent prognostic implications and may be of use in patient management.