title: Clinical significance of poor CD3 response in head and neck cancer.
abstract: OBJECTIVE
  The objective of our investigation was to prospectively study what the implications of an unresponsive CD3 receptor are on clinical outcome in advanced-stage head and neck cancer patients.
  
  
  METHODS
  Lymph node mononuclear cells were purified from cancer patients and stimulated with immobilized anti-CD3 in vitro for 8 days. Two populations were identified, nonresponders (NRs) with [(3)H]thymidine-counts per min (cpm) <3500 and responders (Rs) with cpm >or=3500. NRs and Rs were prospectively followed for a minimum of 24 months, and clinical outcomes were compared. Postoperative complications, length of hospitalization, toxicities associated with chemotherapy or radiation therapy, survival, and disease-free status were measured.
  
  
  RESULTS
  Twenty-six patients were followed, of which 19 Rs [[(3)H](X) = 37,819 +/- 24,979 cpm (mean proliferative count +/- SD)] and 7 NRs ([(3)H](X) = 1,375 +/- 1,102 cpm) were identified. There were no phenotypic differences in lymph node T-cell subpopulations (CD3, CD4, CD8, CD28, CD45RO) between groups. There was a 71% (5/7) incidence of recurrent cancer in NRs compared with 16% (3/19) in Rs; the median disease-free interval was significantly less in NRs (P = 0.03). The risk ratio of Rs to develop a recurrent cancer was 0.237 (95% confidence interval, 0.057-0.994), much less than for NRs.
  
  
  CONCLUSIONS
  Patients with an unresponsive CD3 receptor as measured by in vitro response to anti-CD3 monoclonal antibodies had a significantly higher incidence of recurrent cancer. Analyses using Cox proportion hazards models demonstrated that CD3 response was the single greatest predictor of reduced disease-free interval. This is the first prospective study to confirm the importance of regional lymph node mononuclear cell CD3 receptor function in head and neck squamous cell carcinoma patients for tumor control.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of California Irvine College of Medicine, Orange 92868, USA. TShibuya@uci.edu
authors.forename: Terry Y
authors.initials: TY
authors.lastname: Shibuya
authors.forename: Nghia
authors.initials: N
authors.lastname: Nugyen
authors.forename: Christine E
authors.initials: CE
authors.lastname: McLaren
authors.forename: Kuo-Tung
authors.initials: KT
authors.lastname: Li
authors.forename: Wei-Zen
authors.initials: WZ
authors.lastname: Wei
authors.forename: Sanghun
authors.initials: S
authors.lastname: Kim
authors.forename: George H
authors.initials: GH
authors.lastname: Yoo
authors.forename: Amy
authors.initials: A
authors.lastname: Rogowski
authors.forename: John
authors.initials: J
authors.lastname: Ensley
authors.forename: Wael
authors.initials: W
authors.lastname: Sakr
mesh_terms: D017252:CD3 Complex / Q000276:immunology*; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D066298:In Vitro Techniques; D007902:Length of Stay; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010641:Phenotype; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D011956:Receptors, Cell Surface / Q000276:immunology*; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology*; D013936:Thymidine / Q000378:metabolism
chemical_list: D017252:CD3 Complex; D011956:Receptors, Cell Surface; D013936:Thymidine