بررسی فعالیت سیستم ایمنی سلولی در بیماران مبتلا به تومورهای سر و گردن و تعیین ارتباط آن با تشخیص، گستردگی و پیش‌آگهی بیماری

    Background & Aim: Considering the role of cellular immunity in prognosis of malignant tumors of the head and neck, especially SCCs(Squamous Cell Carcinoma), we intended to investigate cellular immune system activity in patients with head and neck tumors, whether malignant or benign, and then compare it with the kind, severity and prognosis of tumoral involvement. Patients & Method: This is a cross-sectional study performed on 40 head and neck tumor patients in Hazrat-e-Rasoul and Firouzgar hospitals from November 2003 to June 2005. After skin testing with DNCB(Dinithrochlorobanzen) and grading skin reactions, blood sampling was performed within 3 weeks and after isolating, culturing, and stimulating the lymphocytes with PHA(phytohemaggulotini) stimulant, the amount of cytokine production was measured using ELISA(Enzyme Linked Immunosorbent Assay) method. Then the results were compared with the information pertained to pathologic diagnosis, the stage of the disease, and also the results of clinical follow-up. Results: Patients with more advanced malignant tumors(stages 3&4) had weaker skin reactions compared with the early stages of the disease(10.5% contre 87.5% p<0.001). Also in epithelial malignant tumors, skin reactions were weaker than non-epithelial and benign tumors(40% contre 90%). With increasing stages of the malignant disease(up to stage 3), IL-2(Interlukin-2) production also increased but in the fourth stage there was a significant reduction in IL-2 production(P<0.01). Similar findings were also noted about IL-12 and INF-G (Interferon-gama) but they were not statistically significant. In this study there was not a significant relationship between the grade of skin reaction and cytokine production. The follow-up revealed that 3 out of 4 expired patients had weak skin reactions and very low levels of IL-2. Conclusion: This study showed a significant relationship between the grade of skin reaction and pathologic diagnosis and the stage of the disease. Also, levels of IL-2 production decrease significantly in the late stages of the malignant disease. Significant relationship between cellular immune system activity and the kind and severity of tumoral involvement can influence our decision on the choice of treatment and also help us predict the prognosis of the tumoral disease.