METHODS.Using affinity chromatography, IgG1, IgG2, and total IgG were determined in 36 patients with colorectal carcinoma of different stages and compared 1 Department of Biochemistry, University of with 162 apparently healthy controls. Graz, Graz, Austria.
RESULTS.It was found that: 1) the mean values for %IgG1 and %IgG2 of all carci-2 Department of Surgery, University of Graz, noma patients differed significantly from those of the controls; 2) no quantitative Graz, Austria.association was found with tumor stages, and four of five patients with incipient adenocarcinoma within a polyp exhibited the characteristic shift in IgG subclasses; 3 Department of Medical Chemistry, University 3) based on a calculated cutoff, the specificity and sensitivity of %IgG1 to discrimiof Graz, Graz, Austria.nate between controls and carcinoma patients was found to be 88% and 74%, 4 Department of General and Experimental Parespectively; and 4) a quantitative correlation between individual %IgG1 values thology, University of Graz, Graz, Austria.and the probability of correct assignment to carcinoma patients or controls was established.CONCLUSIONS. The significant decrease in %IgG1 accompanied by an increase in %IgG2 in total serum IgG represents an indirect, tissue nonspecific, and early marker of malignant proliferation that distinguishes colorectal carcinoma patients from healthy controls with a specificity of 88% and sensitivity of 74%. T he profile of subclasses within total serum immunoglobulin (Ig)G in healthy persons is tightly regulated to 60 -70% IgG1, 20 -30% IgG2, 5 -8% IgG3, and 0.7 -4% IgG4, independently of absolute serum levels of total IgG ranging between 8 and 18 mg/ml. The authors have previously reported a characteristic shift in the composition of IgG subclasses in close association with malignant tumors of various tis- nign diseases did not show comparable findings, nor was such a dysproteinemia observed in other nonmalignant diseases. With cerReceived July 31, 1996; revision received December 3, 1996; accepted December 23, 1996. tain tumors this phenomenon exhibited diagnostic sensitivities and