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Prediction of Survival in Gynecological Cancer Based on Immunological Tests¹

Departments of Pathology [I. J. C., R. L. H., K. D. R.] and Obstetrics and Gynecology [A. L. H.], University of Chicago, Chicago, Illinois

Patients with advanced cancer have a depressed immunological function. We performed a battery of tests on peripheral blood samples from 42 patients with gynecological cancer to determine the extent to which this depression was due to abnormal lymphocyte function, as compared to changes in the number of lymphoid cells in the peripheral blood or in the efficiency of purification of cells in Ficoll:Hypaque gradients in preparation for testing. The percentage of lymphocytes in the gradient-derived cell suspension (% LG) and the absolute lymphocyte count were more informative than mitogen stimulation, mixed leukocyte culture, and T- and B-cell measurements. Both values decreased significantly with the advancing stage of cancer, and we were able to predict survival of patients with uniform stage of disease. The % LG correlated with survival better than did any other test when multivariate analyses of all test combinations were performed. Low values of % LG reflected both the depressed lymphocyte counts and the altered buoyant density of the leukocytes of many patients with advanced cancer. A large portion of the depression in other immune function tests was statistically attributed to changes in % LG and the lymphocyte counts. We concluded that these two simple measurements provide valuable information about patients with gynecological cancer.

¹ Supported by Grant CA 14599 from the National Cancer Institute and by the Mothers' Aid Research Fund of the Chicago Lying-in Hospital. Part of this work was presented at the meeting of the Federation of American Societies for Experimental Biology in Anaheim, Calif., April 1980.

² Present address: Department of Pathology and Laboratory Medicine, Emory University Medical School, Atlanta, Ga. 30322.

³ To whom requests for reprints should be addressed.

Received 5/27/80. Accepted 9/ 8/80.