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Complement level and tuberculin reactivity were measured as possible indices of the humoral and cell-mediated immune status of 167 patients with head and neck cancer examined at the Department of Otorhinolaryngology, Keio University School of Medicine, Tokyo, between July 1974 and June 1979. Complement level (CH50) was measured according to Mayer's method. In tuberculin tests, 0.1 ml of purified protein-derivative solution (0.5 μg/ml) was injected intracutaneously and formation of erythema and induration was measured 48 hr later. Results were analyzed according to the method of Nishioka, in which the following six stages were classified: stage 0, unaltered tuberculin reactivity and depressed complement level; stage I, unaltered tuberculin reactivity and normal complement level; stage II, unaltered tuberculin reactivity and elevated complement level; stage III, depressed tuberculin reactivity and elevated complement level; stage IV, depressed tuberculin reactivity and normal complement level; stage V, depressed tuberculin reactivity and depressed complement level.
Patients were divided into seven different groups: pre-treatment, postradiotherapy, post-surgery, remission, 5-year survival, recurrence and metastasis, and terminal. Complement level was elevated in tumorbearing hosts, meanwhile it was within the normal range in non-tumor bearing hosts. Values of tuberculin reactivity and CH50 were averaged within each group and analyzed as described above. The results of this study demonstrate that the complement system is elevated while the cell-mediated immune system is depressed in patients with malignant tumors. Thus, this classification system may prove clinically useful in planning treatment of cancer patients and in estimating their prognosis.
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Received: April 1, 1981
© 1981 Society for Promotion of International Otorhinolaryngology (SPIO). Published by Elsevier Inc. All rights reserved.