We examined tumor infiltrating leukocytes (TIL) in frozen sections of 28 biopsies from squamous cell carcinomas of the head and neck (SCCHN). In so doing, we used monoclonal antibodies (MoAb) directed against various leukocyte antigens. As defined by HLe-1+ cells, leukocyte infiltration was present in all biopsies. The amount of HLe-1+ cells was more often greater in stage III than in stage IV lesions. Most of the TIL were identified as CD5+ T-lymphocytes. In contrast, CD19+ B-cells were sparse in most biopsies. CD14+ monocytes/macrophages were found in only a few specimens. The relative proportion of CD4+ T-helper cells was higher than or at least equal to CD8+ suppressor/cytotoxic cells in all samples tested. Interleukin-2 (IL-2) receptor+ lymphocytes were evident in 13 of 22 biopsies stained for CD25 reactivity, and were more often observed in stage III than in stage IV tumors. All biopsies from recurrent tumors had no detectable IL-2 receptor+ cells. Our findings provide evidence for a positive correlation between a greater amount of TIL in earlier stages of SCCHN. The presence of IL-2+ lymphocytes suggests that SCCHN may be capable of activating resting lymphocytes for further IL-2-induced proliferation.
Twenty-one patients with advanced previously untreated squamous cell carcinoma of the oral cavity, oro- and hypopharynx and supraglottic region were treated with combined cis-platinum-methotrexate-bleomycin chemotherapy. Methotrexate (20 mg/m2) was given on day 1, after prehydration cis-diaminodichloroplatinum (60 mg/m2) was given with mannitol diuresis on day 2. From day 3 until day 8 15 mg bleomycin was given daily in a 6-h infusion. Three courses were given every 3 weeks. After clinical evaluation for tumor response all patients were operated and underwent postoperative radiotherapy. After induction chemotherapy eight patients (39%) had a complete, five (24%) a partial (shrinkage of measurable disease more than 50%), and seven (33%) a minor response (more than 25% but less than 50% tumor shrinkage). The neoplasms of the oral cavity and the pharynx responded better than the laryngeal primaries. Exophytic tumors responded better to chemotherapy than the endophytic tumors. Histopathologic examination in serial sections demonstrates in all cases--even after clinically complete response--some small rests of tumor in local fibrotic tissue often underneath a regrown mucosal epithelium.
Frozen tissue sections of biopsies from head and neck squamous cancer lesions were examined for immunohistochemical staining with a recently developed monoclonal antibody, designated as SQM1 antibody and directed against the surface membrane of squamous carcinoma cells. SQM1 antibody stained selectively squamous carcinoma, while normal mucosa and cells of the stroma were non-reactive. Positive staining of tumor was found in 33/35 specimens obtained from several major sites of the head and neck area and was observed in primary manifestations and lymph node metastases as well as in recurrences. The most consistent reactivity was seen with carcinomas of the tongue. Well differentiated squamous carcinomas contained a higher proportion of SQM1 positive tumor cells than poorly differentiated carcinomas. We suggest that the SQM1 antibody may aid in the immunohistochemical identification of squamous carcinoma of the head and neck area.
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