[Immunological studies on patients with tonsillar carcinoma: progress?]

Of 101 consecutive cases of tonsillar carcinoma, 76 were finally selected as fulfilling the statistical requirement of the study. 25 of the cases were excluded because of deficiency of follow-up information. Actuarial survival time up to five years was compared with tumor staging and grading as well as with immunological parameters measured. Autologous and allogeneic anti-tumor antibodies were used for diagnostic purposes. Lymphocyte subpopulations, their distinction and in vitro function as suppressor cells was measured during the course of the disease. Actuarial five years survival time was 55%. Males contributed with 76% of the patients usually showing more progressed disease than females. Antibodies directed against tumor cells were found in all patients but not in healthy volunteers. A mean of 15% of immunofluorescence positive tumor cells revealed the best sensitivity, specificity and progressive value in terms of recurrencies. 5.8 months after reappearance of positive cells in the former operation area recurrencies could be proven histologically. 6.8 months later on the patients had died. Neither course of disease nor staging or grading of tumors showed a significant influence on lymphocyte subpopulations. In later stages in less differentiated tumors T-suppressor phenotypes showed an increase in numbers as compared to T-helper-cells. In parallel a significant rise of in-vitro suppressor activity of peripheral and lymph node lymphocytes could be detected. It is suggested that the rather good survival time is due to an intensive postoperative care and multiple hints from various immunological tests in addition to clinical signs. They allow to intensify directly the therapeutic and hygienic measures needed.