[A study on the role of granulocytes in carcinoma-bearing hosts--G/L ratio as a new host indicator]

It has frequently been observed that the proportion of granulocytes in peripheral blood of cancer patients increases as their cancer progresses, leading some to conjecture that this phenomenon is correlated with the patient's clinical condition. To investigate this possible relationship, the authors conducted the investigations into the number of granulocytes present in cancer patients. First, in experiments on peripheral blood granulocytes in healthy subjects, we examined surface carbohydrate antigens using monoclonal antibodies, and the effect exerted on the self's NK activity by the addition of granulocytes. As a result, it became clear that granulocytes, unlike lymphocytes, have many antigens in common with cancer cells, and that the self's NK activity is suppressed as more and more granulocytes are added. We next investigated whether the patient's clinical condition can be ascertained by analyzing the change over time of the G/L ratio, i.e. the ratio between the numbers of granulocytes and of lymphocytes present in peripheral blood. In the control group the G/L ratio was 1.4 +/- 0.1. For patients with advanced cases of stomach cancer scheduled to undergo surgery, G/L ratios were measured before the operation, in the stable period for two months after the operation, and at the time of readmission to the hospital because of relapse. The pre-surgery patients in stage I to III shared the same value as the healthy control group, but those in stage IV had a significantly higher ratio. As for the relationship between G/L ratio and clinical condition, stage III and IV patients, whose progress we were able to follow for only a short time, showed a decline in the ratio after surgery. When the patients relapsed, however, their G/L ratio rose again. Since this fluctuation in the ratio reflects well the host's clinical status, the G/L ratio can be used as an indicator during treatment. It also proved useful in cases in which no tumor marker exists.