
The immunobiology of skin cancer was studied with thymus-dependent lymphocyte (T cell) levels (an in vitro measure of cellular immunity), with lymphocytic infiltration (LI) of the tumor (an in vivo measure of host-tumor relationship), and with HL-A typing (a genetic measure of histocompatibility). The T cell levels in preoperative patients with squamous (SCC) and basal (BCC) cell carcinoma were significantly lower than in the non-cancer control population (normals). The T cell levels were significantly lower in patients with large tumors than in those with small tumors. The T cell levels remained significantly low in patients cured of large tumors, but were normal in those cured of small tumors. Patients with Bowen's disease not only had T cell levels significantly lower than normal (as a group), but there was also a significant increase in the number of patients who had T cell levels less than two standard deviations below the normal mean. This may signify that they have a greater risk of developing a second kind of malignancy elsewhere. There was a direct correlation between the degree of lymphocytic infiltration (LI) of the tumor, the tumor size, and the T cell level. Small, well-localized tumors had a marked LI and high T cell levels--while the large, deeply invasive tumors had a minimal, or absent, LI and low T cell levels. The presence of HL-A antigens 1 and 8 correlated both with a tendency toward large tumors and with low T cell levels. This may represent the association of a human immune response gene with the human histocompatibility locus. Possibilities for the application of these findings in the clinical management of skin cancer are discussed.
Adult, Immunity, Cellular, Xeroderma Pigmentosum, Skin Neoplasms, Histocompatibility Testing, T-Lymphocytes, Middle Aged, Immune Adherence Reaction, Antigens, Neoplasm, Carcinoma, Basal Cell, Histocompatibility Antigens, Carcinoma, Squamous Cell, Ethnicity, Humans, Aged
Adult, Immunity, Cellular, Xeroderma Pigmentosum, Skin Neoplasms, Histocompatibility Testing, T-Lymphocytes, Middle Aged, Immune Adherence Reaction, Antigens, Neoplasm, Carcinoma, Basal Cell, Histocompatibility Antigens, Carcinoma, Squamous Cell, Ethnicity, Humans, Aged
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