In vivo nonspecific macrophage chemotaxis in cancer patients and its correlation with extent of disease, regional lymph node status, and disease-free survival.

We have used a test to evaluate macrophage migration in vivo, derived from the technique of Rebuck. The test is based on counting the absolute number of macrophages that migrate into an inflammatory site determined by a standardized superficial skin abrasion. It was applied to the study of macrophage migration in cancer patients in different clinical situations. Macrophage migration was virtually abolished in patients with metastatic cancer as compared to healthy controls. In patients with resectable breast and lung tumors, the test performed preoperatively correlated closely with lymph node status as determined by pathological examination after operation. Patients without lymph node involvement showed a significantly stronger response than did controls, whereas those with lymph node involvement had a diminished or even an abolished response. Distinctive subgroups were characterized among patients both with and without lymph node involvement on the basis of their macrophage response, and these subgroups proved to have distinctly different prognoses, particularly the patients without lymph node involvement with a poor macrophage response who had an unusually poor prognosis. It is concluded that this test shows potential for predicting the prognosis among categories of patients hitherto considered as homogeneous, although further evaluation in larger numbers of patients is necessary.