Changes in Immunocompetence of Lung Cancer Patients in Various Therapeutic Modalities

Abstract

To clarify immunological developments in the cancer host I monitored both cellular and humoral immune parameter changes in 225 lung cancer patients. Tuberculin reaction was used as the parameter of cellular immunity and serum complement levels, βIC/βIA globulin, βIE globulin, immunoglobulin IgG, IgAand IgM as parameters of humoral immunity. Tuberculin reaction decreased as the clinical stage advanced. These results reflect the diminished cellular immunity in these patients. Serum complement levels for all stages were high. Complement components were at normal levels. IgG levels for all stages were high while IgA and IgM levels were within normal ranges. Next I examined movements of several immune parameters according to therapeutic modality. Tuberculin reaction decreased in cases receiving radiotherapy and/or chemotherapy but on the other hand, it increased as a result of BCG-CWS non-specific immunotherapy. Other parameters showed no tendency to move. Examining movements of the parameters in relation to prognosis, tuberculin reaction increased in cases with good courses. On the other hand, in cases with poor courses the tuberculin reaction went down. Other parameters did not show any particular course-related tendency. I examined each cases according to a six-stage classification system of immune response which is based on the idea that the complement system compensates lower cellular immunity. With advance in clinical stage a definite counter-clockwise movement through higher stages was seen. Cases with good courses showed movement in a clockwise direction as did cases BCG -CWS non-specific immunotherapy. Cases with long survival moved to clockwise direction coming together in stage I or II in the six-stage classification. Cases which developed recurrences or metastasis moved in a counter-clockwise direction. These results show that the six-stage classification of immune response is a very useful and vaild method to observe and evaluate the host's immunity, to determine treatment and to estimate the prognosis in lung cancer patients. It was also seen that BCG-CWS non-spesific immunotherapy is effective in stimulating the immune response in lung cancer patients.