Sequential evaluation of general immunocompetence in gynecologic cancer

A sequential evaluation of general immunocompetence was performed in 70 previously untreated patients with gynecologic cancer. Immunologic evaluations were made prior to any therapy and repeated every 3-4 months for 3 years or until patients died of disease. Cell-mediated immunity was investigated by delayed hypersensitivity to intradermal skin test antigens (STA) and by contact sensitization to 2,4-dinitrofluorobenzene (DNFB). Serum immunoglobulin determinations were performed to evaluate humoral immunity. Compared with age-matched controls, there was impairment of cell-mediated response to both STA and DNFB in patients with locally invasive and disseminated cancer but not in those with preinvasive cancer. There was a progressively impaired reactivity with clinical progression of disease independently of histological type of neoplasm. Sequential evaluations revealed that variations in immune reactivity occurred that also correlated with the patient's clinical course. Significant changes in immunoglobulin levels, an increase in IgG and IgA, and a decrease in IgM, were observed in the cancer groups as compared with age-matched healthy female controls. However, neither initial values nor sequential determinations of immunoglobulins were related to the clinical course of gynecologic cancer.