In an immunological study of 288 colorectal carcinoma patients, we investigated the relationship between survival and preoperative in vitro antibody-dependent cellular cytotoxicity (ADCC) against the colonic carcinoma cell line HT-29. A highly significantly favorable (p = 0.001) association was found in the 20 female patients with ADCC. Nearly all (97%) of the 66 patients with ADCC were blood group O, but blood group per se did not relate to survival, nor could staging explain the survival association with ADCC. The mechanism whereby ADCC or its in vivo expression confers a survival advantage is unknown but we suggest that it derives from immunoreactivity against blood group A antigens produced inappropriately in the carcinomatous epithelium of the group O and B patients.
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