Immunity in esophageal carcinoma.

Area of Science:

• Immunology
• Oncology
• Gastroenterology

Background:

• Esophageal carcinoma is associated with significant morbidity and mortality.
• Cell-mediated immunity plays a crucial role in cancer surveillance and response.
• Understanding immune status in esophageal cancer is vital for treatment strategies.

Purpose of the Study:

• To investigate cell-mediated immunity and immunoglobulin levels in patients with esophageal carcinoma.
• To assess the impact of tumor burden, radiotherapy, and nutritional support on immune parameters.

Main Methods:

• Evaluated in vivo sensitization with recall antigens and DNCB.
• Quantified T-cell counts and assessed blastogenesis index with PHA.
• Measured serum IgA, circulating immune complexes, and CEA levels.
• Assessed changes following radiotherapy and enteral alimentation.

Main Results:

• Markedly depressed in vivo sensitization (13-16% positivity) and low T-cell counts (24 +/- 14) compared to controls (61 +/- 23).
• Significantly reduced blastogenesis index with PHA (1.75 +/- 1.04) versus normal (6.79 +/- 2.57).
• Elevated IgA levels (298 +/- 184 mg/100 ml) in untreated patients compared to normal (154 +/- 54 mg/100 ml); IgA showed a downward trend with hyperalimentation.
• Elevated circulating immune complexes and serum CEA in ~50% of patients.

Conclusions:

• Tumor-related impairment of cell-mediated immunity is confirmed in esophageal carcinoma.
• Radiotherapy further depresses cell-mediated immunity, with no improvement from enteral alimentation.
• Nutritional status appears to influence immunoglobulin A levels, but not the overall cell-mediated immune deficit.