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Immunoglobulin and complement inclusions in peripheral blood polymorphonuclear leucocytes of patients with bronchial carcinoma

Jansen, H. M., The, T. H., de Gast, G. C., Huiges, H. A., Esselink, M. T., Van der Wal, A. M., and Orie, N. G. M.Thorax, 32, 706-710. Immunoglobulin and complement inclusions in peripheral blood polymorphonuclear leucocytes of patients with bronchial carcinoma. Inclusions in peripheral blood polymorphonuclear leucocytes (PMN) of 23 patients with bronchial carcinoma, of 11 individuals with chronic obstructive lung disease (COLD), and of 11 healthy controls were studied by the indirect immunofluorescence technique for IgG and complement. The relationships of these inclusions to the clinical stage and histology of the malignant disease as well as the influence of subsequent therapy were studied. Patients with disseminated bronchial carcinoma, stage III, had higher PMN scores than patients with localised disease, stage I. Both patient groups had higher scores than the two control groups. The differences were all statistically significant. There was no difference between the COLD group and the healthy controls. PMN inclusion scores from the patient group with small- or large-cell undifferentiated carcinoma were higher than from patients with moderately differentiated or well differentiated squamous-cell carcinoma. The first two groups differed significantly from the controls; the latter group did not. Curative surgical therapy gave rise to a significant drop in PMN scores to normal values. In four patients with regional lymph node metastasis (stage II) the PMN inclusions were related to evidence of recurrence at six months follow-up after operation and BCG immunostimulation. It is concluded that the PMN inclusions are related to the extent of the disease, to the histological type, and to curative surgical therapy. The possible relation to immune complexes of tumour antigen-antibody origin is discussed.