THE CLINICAL AND PATHOLOGICAL STUDY OF BLADDER CANCER
I. Immune Evaluation with Skin Testing
1978 Volume 69 Issue 8 Pages 1035-1043
Details
1978 Volume 69 Issue 8 Pages 1035-1043
To evaluate cell-mediated immunocompetence of patients with bladder cancer, skin reactivity to 2, 4 dinitrochlorobenzene (DNCB) and tuberculin (PPD) as delayed cutaneous hypersensitivity were examined in 42 controls (without cancer) and 62 patients with bladder cancer.
1) A significant difference in DNCB responsiveness was present between patients with bladder tumor and normal controls. 45 per cent (25/55) of the patients with bladder cancer were DNCB-positive compared to 87 per cent (26/30) of the control group. DNCB reactivity was depressed especially in patients with recurrent or metastatic cancer.
2) The rate of positive reaction to DNCB was higher among the patients who underwent conservative therapy than the patients who underwent radical operative procedure. Fathermore, inoperable cases were all DNCB-negative.
3) There was no difference in DNCB responsiveness among grade I, II and III, but DNCB responsiveness of grade IV was significantly depressed compared to grade I, II and III.
4) Only 7 per cent (1/15) of the patients with high stage cancer were DNCB-positive compared to 63 per cent (19/30) of the patients with low stage, which indicated a difference in immunologic responsiveness correlated with the tumor stages as measured by DNCB skin reactivity.
5) DNCB responsiveness of the patients with tumor over 2cm in diameter or multiple tumor were significantly depressed. It was suggested that there was definite correlation among immunologic defficiency, tumor growth and multiplicity.
6) Although only 9 per cent (1/11) of the patients who showed positive reaction to DNCB died in the follow up period, 38 per cent (8/21) of the patients who showed negative reaction died of widespread metastasis or cachexia and 75 per cent (6/8) of the deceased died within 6 months.
7) There was no significant difference in immunologic responsiveness among tumor grades and tumor stages as measured by PPD skin reactivity.
These results indicated that skin reaction to DNCB was one of the important parameters to evaluate cell-mediated immunocompetence of the patients with bladder cancer.
