Inhibition of leukocyte migration by human tumors. Effect on patient survival

Inhibition of Leukocyte Migration by a Human Colon Cancer Extract

The direct leucocyte migration inhibition test in capillary tubes was used to test 10 patients with colonic adenocarcinoma against KCl soluble extracts of an allogenic colon cancer and an allogenic normal colon fragment. Inhibition was consistently found with the cancer extract but not with the normal tissue extract. None of the control group of patients affected by other tumors, intestinal and liver disorders showed a migration inhibition in response to the colonic tumor extract. Our findings strongly suggest the presence of a tumor-associated antigen in the cancer extract.

Tumor specific reactivity during development of N-methyl-N-nitrosourea-induced rat colon cancer

Invasive colon adenocarcinomas with lymph node metastases can be induced in Sprague-Dawley rats by 15 weekly intrarectal injections of 2 mg N-methyl-N-nitrosourea (NMU). Extracts were prepared from invasive adenocarcinomas and normal rat colon mucosa by a 2 phase gradient. Mixed leukocyte tumor interaction (MLTI) assays stimulating lymphocytes from tumor-bearing and normal rats were performed using these extracts. Quadruplicate cultures were established with 2 X 10(5) lymphocytes and tumor or normal colon extract. Cultures were pulsed with H3 thymidine at 7 days and harvested 6 hours later. Results were expressed as net counts (experimental CPM minus background CPM). Reactivity in tumor-bearing animals was first seen when rat colons showed intraepithelial dysplasia histologically and was maximal when early invasive colon tumors were present. No difference in stimulation was seen between tumor-bearing and normal animal lymphocyte reactivity with normal colon extract. In conclusion, animals with NMU-induced rat colon cancer show specific tumor reactivity in MLTI assays. Immune reactivity in these animals may provide clues to clinical tumor status by immunologic assay.

Human intracranial tumors: effect of autologous serum addition on leucocyte migration inhibition

42 human intracranial tumours were investigated by the leucocyte migration inhibition technique at various antigen concentration with and without autologous serum addition. A correlation was found between migration rate and antigen concentration. Autologous serum addition resulted in a non-specific stimulation of migration, however, stimulation by immune complexes was also present. Migration stimulation, as an in-vitro-equivalent of immunologic tumor enhancement, is discussed.

Cellular hypersensitivity to autologous tumor extract in patients with breast carcinoma

The indirect macrophage migration inhibition technique was used to study cellular hypersensitivity to autologous tumor extract in relation to the progress and prognosis of breast carcinoma. Cellular immune response, evidenced by production of a macrophage migration inhibitory factor (MIF), was noted preoperatively in 21 of 63 patients (33 per cent). This reactivity was used at the time of surgery to determine the grade of the primary tumor, lymph node involvement and the stage of the disease according to the TNM system. The five-year survival rate was 76 per cent for patients whose lymphocytes responded preoperatively and 54 per cent for patients whose lymphocytes did not respond, indicating that this assay may be valuable in detecting cellular immune response to breast carcinoma and in evaluating the immunological status of patients.

Economic status and survival of cancer patients

The relation of economic status to survival was studied for 39 kinds of cancer representing all types for which 60 or more indigent patients were seen in University of Iowa Hospital for primary care during the years 1940-1969. For every type the indigent patients had poorer survival than non-indigent patients. Quality of care would be eliminated as a major variable since a second group of "ward" patients of higher economic status was available for comparison and the differences were substantially greater between the two groups of teaching patients than between the "clinic pay" and "private" patients. Age differences and differences in stage of disease accounted for less than half of the survival deficits in the indigents. The two important problems were high mortality from causes other than cancer and excess cancer mortality not accounted for by stage differences, particularly among patients who should have had 5-year survival rates between 40 and 70%. In these patients cancer recurred more often and earlier among the indigent. We postulate host differences associated with poverty that could also account for much of the observed Black-White differences as well as some international differences in cancer survival rates.

Detection of human tumor-associated antigens by the leukocyte migration in agarose assay

Twenty-three of 36 (64%) lung cancer patients, 19 of 36 (54%) melanoma patients and 18 of 27 (66%) sarcoma patients tested in the leukocyte migration in agarose assay against soluble extracts of histologically similar tumors showed significant inhibition of leukocyte migration. Reactivity to extracts of dissimilar tumors was low. Sera of only 1/13 (7%) lung cancer patients, 2/19 (10%) melanoma patients and 7/21 (33%) sarcoma patients were inhibited by extracts of histologically dissimilar tumors. Only 7-9% of cancer patients reacted to paired extracts of normal tissue from the tumor donors. An average of 13% of sera from normal controls reacted to tumor extracts. Stage of disease and mode of therapy appeared to have little effect on overall reactivity in this assay, although the number of patients within the various categories was small for purposes of statistical analysis. The leukocyte migration in agarose assay shows a sensitivity and specificity to tumor-associated antigens comparable to that of the older capillary tube method in general use and may facilitate performance of migration inhibition. This assay may not be useful as a prognostic test due to the lack ofcorrelation with stage of disease and treatment modality. However, its high specificity and economical use of tumor antigen suggest applications in tumor antigen purification. The use of soluble tumor antigen preparations may make it possible to purify these antigens further to increase specificity and reactivity.

In vitro detection of cellular immunity to melanoma antigens in man by the monocyte spreading inhibition test

In vitro inhibition of monocyte spreading (a correlate of cellular immunity) was used to detect cell-mediated immune reactions of melanoma patients to specific melanoma antigens. Two soluble preparations of human melanoma antigens (MA-1 and MA-2) and one of a breast carcinoma (BCA) were prepared. The preparations were incubated in vitro with mononuclear cells isolated from the blood of 24 patients with melanoma, six patients with malignancies other than melanoma and 14 healthy donors. Spreading of monocytes from healthy donors was not inhibited by either MA-1 and MA-2 or BCA. MA-1 and MA-2 significantly inhibited the spreading of monocytes from patients with melanoma, while monocytes from patients with other malignancies were not affected. Spreading of monocytes from patients with melanoma was inhibited by the preparation of BCA. We conclude that inhibition of monocyte spreading can detect, in vitro, a cellular immune reaction to specific melanoma antigens in patients with melanoma.

Inhibition of human leukocyte migration in agarose by kcl extracts of carcinoma of the lung

The leukocyte migration in agarose assay recently developed by Clausen (Clausen, 1971), was used to test 22 lung cancer patients against soluble extracts of allogeneic lung cancer and allogeneic normal lung. Seventeen were inhibited to a significantly greater degree by at least one tumor extract (average migration index (MI equals 0.58) than by the corresponding normal lung extract (average MI equals 0.83). DNCB-positive and DNCB-negative patients reacted with equal frequency to tumor extracts. Three patients tested against their autologous tumor and normal lung extracts were specifically inhibited by the tumor extract (average MI equals 0.53) but not by the normal lung extract (average MI equals 0.83). None of seven lung cancer patients tested against non-pulmonary tumor extracts was significantly inhibited (average MI equals 1.1). Only 6/53 controls including patients with other tumors, patients with emphysema and age-matched non-smokers showed significant inhibition against any of the lung cancer extracts. These findings strongly suggest the presence of tumor-associated antigens in KCl-solubilized extracts of human lung cancer.