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A Correlative Analysis of in Vitro Parameters of Cellular Immunity in Patients with Squamous Cell Carcinoma of the Head and Neck

Departments of Pathology [M. J. D., S. J. Q.], and Otorhinolaryngology [S. W. C.], The University of Michigan Medical School, and The Department of Biostatistics [M. A. S.], School of Public Health, The University of Michigan, Ann Arbor, Michigan 48109

Multiple parameters of non-tumor-specific immunocompetence were measured in 37 previously untreated patients with squamous cell carcinoma of the head and neck and in 51 controls (23 over age 50). Peripheral blood lymphocytes were separated on a Ficoll-Hypaque gradient and tested for spontaneous rosette formation with unsensitized sheep red blood cells (thymus-dependent cells). They were also tested for blastogenic response ([³H]thymidine incorporation) to phytohemagglutinin- and mitomycin C-treated allogeneic lymphocytes in a one-way mixed-lymphocyte culture in which AB serum-supplemented media were used. The results were compared by clinical stage, tumor size, degree of tumor differentiation, and presence or absence of nodal metastases. A variety of statistical methods, including multivariate analysis, were used to evaluate the data. Decreased percentages of thymus-dependent cells and depressed phytohemagglutinin responses were found in all stages, but the results were not consistent and some patients with advanced tumors had normal results. The patient's mixedlymphocyte culture response was depressed in 27 of 33 experiments and was the only abnormal test in some instances. We conclude that: (a) significant intercorrelations exist among immunological parameters in patients and controls and influence the choice of statistical techniques; (b) many patients with squamous cell carcinoma of the head and neck have defects in non-tumor-specific immunocompetence, but they are not always predictive of extent of malignant disease; (c) no single test will identify all abnormal patients; and (d) controls of an age similar to the patients are important.

¹ Present address: Department of Pathology, University of Pennsylvania, School of Medicine, Philadelphia, Pa. 19104. To whom requests for reprints should be addressed, at Department of Pathology, The University of Michigan, 1335 East Catherine Street, Ann Arbor, Mich. 48109.

Received 5/31/77. Accepted 9/13/77.