Cellular immunity in mammary cancer patients as measured by the leukocyte migration test (LMT). A follow-up study

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.

Skin window reactivity to autologous breast cancer. An index of prognostically significant cell-mediated immunity

The relationship between cell-mediated immunity (CMI) to autologous breast cancer tissue and subsequent clinical behavior has been studied by one of the authors since 1953. In this article the prognostic significance of CMI as measured by a skin window (SW) procedure is reported. The procedure examines cellular responses to coverslip-mounted sections of autologous breast cancer tissue that have been applied to a microabrasion of the skin. Using criteria routinely employed in conventional hematologic and pathologic diagnoses, diverse patterns of SW responses can be identified. Specific patterns are recognizable that are consistent with CMI and that vary significantly with stage and subsequent behavior of the disease. Intrastage variations in behavior were found for patients with invasive breast cancer according to nuclear grade (NG) and postoperative SW reactivity to autologous breast cancer. Positive SW reactivity was associated with a significantly reduced risk of metastases and also appeared to impede the occurrence of metachronous second primary invasive breast cancers. The findings demonstrate the current value of NG and SW response characteristics with regard to prognosis and immunotherapy. Moreover, they are consistent with the development of immunoprophylaxis.

Cell-mediated immunity to human oral carcinoma, and cross reactivity to patients with oral leukoplakia demonstrated by the leukocyte migration test

Tissue extracts from 18 oral carcinomas were tested in the leukocyte migration capillary technique (LMCT) against autologous leukocytes and against leukocytes of healthy matched controls. The normal range was defined as the mean migration index (MI) of the leukocytes of the normal controls +/- 2SD. Three carcinoma patients showed significant inhibition and one was on the lower borderline of the normal range. None showed stimulation. When leukocytes of leukoplakia patients were tested against normal intestine and two homologous oral carcinoma extracts, significantly different MI's were found between carcinoma and normal intestine. The findings are compatible with a state of tissue-specific, cellular hypersensitivity against antigenic components present in oral leukoplakia and in oral carcinoma, and is possibly common between the two.

Reactivity of gastric cancer patients in leucocyte migration inhibition tests to 3M KCl extracts from gastric tumor

Leucocytes from patients with gastric cancer and other malignant and non-malignant diseases of the gastrointestinal tract as well as from healthy controls were tested for leucocyte migration inhibition test (LMI) using five different, allogeneic 3M KCl soluble extracts from gastric cancer tissues. The normal range of migration index (MI) was considered to be between 0.77 and 1.18 by calculating the mean MI +/- 2SD of ten healthy controls with cancer extracts. MIs out of this range were considered to be pathologic. In LMI test with a single tumor extract, pathologic MI was found in 48% of 79 gastric cancer patients, such being significantly higher than in those (4-21%) of three other groups of patients. In the panel mode of LMI, i.e., testing each blood sample with five different tumor extracts, 79% (62/79) of patients with gastric cancer were reactive, while 25% (5/20) of colorectal cancer patients showed "positive" reaction and no "positive" reactivity was observed in two other groups of patients. Thus, the "positive" reactivity in patients with gastric cancer was observed significantly higher than those in the other 3 groups of patients. Gastric cancer extracts had a wide range of cross-reactivity when compared with colorectal tumor extracts which showed a relatively restricted cross-reactivity. Thus, the LMI tests, particularly when tested by a panel mode, seems to express cell-mediated immunity against tumor associated antigens of gastric cancer.

Leukocyte migration inhibition assay in patients with prostate adenocarcinoma

The leukocyte migration inhibition (LMI) assay was used to determine the cell-mediated immune reactivity of prostate cancer patients to putative tumor antigens present in potassium chloride extracts of surgically removed prostate tumor tissue. Using an extract prepared from prostate tumor tissue, inhibition of leukocyte migration was found more frequently in prostate tumor patients (61%) than in patients with benign prostate hyperplasia (37%), patients with nonprostate cancers (26%), or normal donors (10%). Control extracts prepared from normal prostate tissue, benign prostate hyperplasia tissue, and unrelated tumor tissue were statistically less reactive in the LMI assay than the prostate tumor extract when reacted against leukocytes from prostate tumor patients. These results suggest that the LMI assay might be potentially useful for measuring the tumor-directed, cell-mediated immune responses in patients with prostate cancer.

Circulating breast tumour antigen-sensitive T lymphocytes in early breast cancer and high risk benign breast disease

Levels of circulating T lymphocytes sensitized to breast tumour associated antigens (BTA) were correlated with pathological tumour stage or benign histopathology in preoperative studies of 180 patients by the antigen-stimulated active rosette-forming T cell (AgARFC) assay. Incubation of lymphocytes with allogeneic BTA extracts produced increased AgARFC compared with incubation without BTA. Significant levels of BTA-sensitive T cells were found in 78 per cent of breast cancer patients compared with 23 per cent of patients with benign disease (P less than 0.0005, by X2). Over 93 per cent of stage I cancer patients responded to BTA, compared with 69 per cent of stage II patients (P less than 0.025) and 59 per cent of stages III-IV patients (P less than 0.005). Twenty-nine per cent of 42 patients with fibrocystic disease were positive to BTA in contrast to 8 per cent of 25 patients with fibroadenomas. This was a 3.6-fold higher incidence of BTA-sensitive T cells associated with fibrocystic disease than with fibroadenomas, which was in agreement with the increased breast cancer risk rate associated with fibrocystic disease. These findings suggest that the AgARFC assay may detect early malignant change in fibrocystic disease. The AgARFC assay was found to reliably detect early invasive carcinoma.

Leukocyte migration inhibition assay in patients with bladder cancer

The leukocyte migration inhibition assay has demonstrated successfully tumor-associated antigenic activity in protein extracts of cell culture lines of a number of neoplasms. Our data have shown a high degree of leukocyte migration inhibition reactivity with protein extracts from the well characterized T-24 transitional carcinoma cell line. Thus, the leukocyte migration inhibition assay may prove a valuable method of in vitro assessment of the cell-mediated immunity of bladder cancer patients and as a method to monitor attempts at further purification of tumor-associated antigens.

Randomized trial with Poly A-Poly U as adjuvant therapy complementing surgery in patients with breast cancer: in vitro study of cellular immunity

The immunologic reactivity of patients with initially operable breast cancer was measured by the leukocyte migration inhibition test using autologous tumor extract (T), autologous serum (S), and a combination of both (T + S). These patients formed part of a randomized clinical trial comparing, on the one hand, conventional treatment and, on the other, conventional treatment complemented by injections of poly A-poly U. A sequential study was carried out on 159 patients, testing them 7 days, 2 months, 4 months, and 1 year after the operation. Statistical comparisons revealed no significant difference in the reaction of the two groups. In addition, no significant differences were found between those with lymph node involvement and those without. Radiotherapy given to those with lymph node involvement did not significantly change their reactions. We were able to show that the percentage of patients with a positive leukocyte migration inhibition test (LMIT) increases regularly and significantly with time. This study confirmed the presence in some autologous serum of a synergistic factor (SS factor) which increased the inhibition of migration of leukocytes by autologous tumor extract. This factor was found in 18 patients, equally divided between both therapeutic groups. In the group with SS factor, the percentage with lymph node involvement appeared greater (83% compared with 68% among those patients who had no SS factor), and the incidence of metastases was also increased (44% compared with 21%). This factor seemed to indicate a bad prognosis. However, there was a difference in the results between the two therapeutic groups in patients with the synergistic factor. Of nine patients undergoing conventional treatment, six had devleoped metastases, whereas only two out of the nine patients who also poly A-poly U developed metastases. The same trend was observed in the whole trial population.

Cell-mediated immunity in patients with renal cell carcinoma as measured by leukocyte migration inhibition test

The cell-mediated immune (CMI) response to tumor-associated antigens present in 3 M KCL extracts of renal cell carcinoma tissue was measured in patients with renal cell carcinoma (RCC) by the leukocyte migration inhibition (LMI) test. Of 30 patients with histologically proved RCC, 19 (63%) gave a positive LMI test; whereas, 2 of 28 (7%) of the normal donors, 13 of 43 (30%) patients with other cancers, and 5 of 14 (36%) benign kidney disease patients gave positive tests. Thirteen per cent of RCC patients reacted to a normal kidney extract. Although 33% gave a positive response to a lung carcinoma extract, the incidence of reactivity was less than that observed with the lung cancer patients. These results suggest that a CMI response to a renal carcinoma-associated antigen was measured by the LMI test. Correlation of the LMI data with the stage of disease and clinical status indicated that 71% of patients that had a localized tumor and were clinically free of disease one year postnephrectomy lost their tumor-directed CMI response. Patients with distant metastasis (Stage D) were LMI positive provided they had not received radiation or hormone therapy at the time of testing. These results suggest that the demonstration of CMI, as measured by the leukocyte migration inhibition test, correlates with the presence of active disease.

Factors interfering with cellular immunological responses to the murine mammary tumor virus in tumor-bearing mice

T-cell-enriched spleen cell fractions from BALB/c mice bearing virally induced mammary tumors become unresponsive with progressive tumor growth in the lymphocyte blastogenesis test, using purified mammary tumor virus (MTV) as an antigen. reactivity can be restored by mild trypsinization or extensive washing of the cells. When reactive cells from mice immunized with MTV were incubated with the wash fluid of the initially unresponsive cells. MTV-specific blastogenesis was inhibited. Washings of normal cells had no such effect. Leukocytes from tumor-bearing mice also become unresponsive to MTV in the leukocyte adherence inhibition (LAI) assay. Trypsinization or extensive washing does not restore reactivity. However, such treatment of reactive cells from immunized animals abolishes a positive reaction in the LAI assay, using MTV as an antigen. The washings of spleen cells from tumor-bearing mice inhibit the reactivity of leukocytes from immunized animals. Sera from these mice could block the reaction in both cellular immunological tests. The inhibiting factors appeared early after the onset of tumor growth. By means of the Sepharose bead immunofluorescence assay it was established that wash fluid and sera with blocking activity contain MTV antigens as well as anti-MTV antibodies.

Influence of Autologous Serum on in Vitro Reactivity of Peripheral Lymphocytes of Patients with Breast Cancer

The influence of autologous serum on DNA synthesis and phytohemagglutinin (PHA) or pokeweed mitogen (PWM) stimulation of peripheral blood lymphocytes from mammary tumor-bearing women has been studied. Blood samples were collected from patients at the 4 stages of the TNM classification who had not undergone any therapeutic treatment. Lymphocyte functions were significantly reduced only in patients with the largest tumors and in the latest stage of disease. Autologous cancer sera inhibited spontaneous DNA synthesis of lymphocytes and did not inhibit lymphocyte stimulation by mitogens. It is possible that unrecognized inhibiting and stimulating factors, possibly acting in synergism with mitogens, are present in mammary cancer sera.

An overview: antitumor immunity in breast cancer assayed by tube leukocyte adherence inhibition

The adherence to glass of human peripheral blood leukocytes (PBL) incubated with tumor antigen in vitro, is specifically inhibited if the PBL are sensitized to the antigen. The presence of leukocyte adherence inhibition (LAI) to tumor extracts indicates the presence of systemic antitumor immunity. By the tube leukocyte adherence inhibition assay (tube LAI), it was shown that 85% (191 of 223) Stage I and II, 45% (15 of 34) Stage III and 29% (30 of 103) Stage IV breast cancer patients had LAI reactivity. LAI responsiveness diminished with an increased tumor burden and most patients with advanced cancer exhibited no LAI reactivity. When LAI reactivity was monitored for 1 to 6 months after surgery, 13 of 25 Stage I and II breast cancer patients were negative on the first repeat assay. In general, 7 months after mastectomy most patients clinically free of cancer showed no LAI reactivity. Of thirty-five patients tested between 7 and 18 months after mastectomy, 6 were positive and 4 of the positives had local recurrence. The phenomenon of tube LAI appears to be mediated by monocytes armed with cytophilic antitumor antibody. The serum of patients whose leukocytes responded in the tube LAI assay had free cytophilic antitumor antibody that "armed" or sensitized normal leukocytes to respond in the LAI assay. Serum arming paralleled leukocyte reactivity before and after surgery. Patients with advanced cancer whose leukocytes failed to react in the LAI assay had serum blocking factors (excess tumor antigen) that abrogated the LAI reactivity of leukocytes from reactive patients.