The effect of undernutrition and disease site and stage on cell-mediated immunity in gastrointestinal cancer.
In order to assess whether impairment of cell-mediated immunity in cancer was due to the presence, site and stage of malignant disease or to associated undernourishment, 48 patients with gastrointestinal cancer were compared to 27 patients with benign gastrointestinal disease. Cell-mediated immunity (CMI) was assessed by delayed hypersensitivity (DHS) skin test response to recall antigens and lymphocyte mitogenic response to phytohaemagglutinin (PHA). Patients were grouped according to nutritional status assessed from a history of weight loss and changes in the ratio of total body potassium (TBK mmol) to total body water (TBW kg). The results showed that, whilst cancer patients as a whole had significantly worse DHS response, there were no significant differences between benign and malignant groups of equivalent nutritional status and in both types of disease response decreased significantly with worsening nutritional status (chi 2(2) = 6.83 cancer, 6.11 benign, p less than 0.05). PHA response was significantly worse in the worst nourished cancer patients than in those with normal nutritional status (p less than 0.05, Wilcoxon). Disease site and stage had no significant effect on either test. The results suggest that depression of CMI response in gastrointestinal cancer is due to undernutrition and is not a cancer specific effect.
D000328:Adult; D000368:Aged; D001835:Body Weight; D005260:Female; D005767:Gastrointestinal Diseases / Q000276:immunology; D005770:Gastrointestinal Neoplasms / Q000276:immunology* / Q000473:pathology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007111:Immunity, Cellular / Q000187:drug effects; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009748:Nutrition Disorders / Q000276:immunology* / Q000473:pathology; D010835:Phytohemagglutinins / Q000494:pharmacology; D012882:Skin Tests
D010835:Phytohemagglutinins