A multiparametric observation of immune competence in breast cancer and its correlation with tumour load and prognosis.

A multiparametric observation of cellular immune status by delayed hypersensitivity response to primary and recall antigens, absolute lymphocyte counts, T-cells counts, lymphocyte stimulation to PHA and serum immunoglobulin levels (IgG, IgM, IgA) was done in 60 patients of breast cancer and 40 age-matched normal controls. The findings were correlated with clinical stage, tumour size, lymphnode involvement, distant metastases, tumour differentiation, lymphoreticular response and tumour recurrence within one year of follow-up period. Delayed hypersensitivity response to DNCB, PPD and Candida was significantly impaired (P = less than .001) in breast cancer patients as compared to normal controls. DNCB and candida response showed a gradual decrease with increasing clinical stage and PPD response was impaired in the advanced stage (Stage III and IV). Patients with well-differentiated tumour were more anergic than those with poorly differentiated tumour. Delayed hypersensitivity response to both primary and recall antigen showed a good correlation with tumour recurrence. Patients who had early recurrence or progressive disease were more anergic to all the three antigens. Absolute lymphocyte counts, absolute T-cells and E-rosette were significantly reduced in breast cancer patients as compared to normal controls and further correlated with clinical stage. Absolute T-cells and E-rosettes were lower in patients with lymphnode involvement, and distant metastases as compared to those with localized tumour. Absence of lymphoreticular response was related with impaired T-cell population. Absolute T-cell counts and E-rosettes further correlated with prognosis of the patients being significantly impaired in patients with early recurrence or with progressive disease (P = less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)