Morton D, Eilber F R, Malmgren R A, Wood W C
Tumor Immunology Section, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Surgery. 1970 Jul;68(1):158-63; discussion 163-4.
Antimelanoma antibodies previously demonstrated in the serum of melanoma patients by immunofluorescence have now been detected by a sensitive and quantitative complement fixation technique. The melanoma-specific antibodies detected by both of these techniques show a remarkable correlation with the stage of disease. Study of serums from 63 melanoma patients showed that both the incidence and titer of antibodies to the tumor antigens of malignant melanoma were found to be higher in patients with localized melanoma than in those with widespread metastatic disease. Furthermore, study of serial serum specimens on melanoma patients revealed a drop in antibody titer to undetectable levels with advancing metastatic disease. Additional evidence for the importance of immunological factors in this disease came from studies of delayed cutaneous hypersensitivity in melanoma patients. All patients with localized melanoma were capable of being sensitized to DNCB, whereas all patients who could not manifest delayed cutaneous hypersensitivity to this chemical had widespread metastatic disease. Eight melanoma patients were treated with immunotherapy using BCG as an immunological adjuvant. This therapy produced a rising titer of antimelanoma antibody and temporary tumor regression in five patients. However, only one of these patients has had a complete regression and remains free of disease at two years following treatment. There was a good correlation between the patient's immunological competence and his response to immunotherapy. All patients who could be sensitized to DNCB or tuberculin and developed a fourfold rise in antibody titer had some response to immunotherapy, whereas anergic patients failed to respond to this therapy. These studies indicate that the host immune response to malignant melanoma is an important factor in controlling the progression of this disease. Therefore, immunotherapy may become a useful adjunct to the primary surgical therapy of malignant melanoma.
先前通过免疫荧光在黑色素瘤患者血清中证实的抗黑色素瘤抗体，现在已通过一种灵敏且定量的补体结合技术检测到。通过这两种技术检测到的黑色素瘤特异性抗体与疾病分期显示出显著相关性。对63例黑色素瘤患者血清的研究表明，局限性黑色素瘤患者中针对恶性黑色素瘤肿瘤抗原的抗体发生率和滴度均高于广泛转移性疾病患者。此外，对黑色素瘤患者系列血清标本的研究发现，随着转移性疾病的进展，抗体滴度降至无法检测的水平。黑色素瘤患者迟发性皮肤超敏反应的研究为该疾病中免疫因素的重要性提供了更多证据。所有局限性黑色素瘤患者都能够被二硝基氯苯致敏，而所有对这种化学物质不能表现出迟发性皮肤超敏反应的患者都有广泛的转移性疾病。8例黑色素瘤患者接受了以卡介苗作为免疫佐剂的免疫治疗。这种治疗使5例患者的抗黑色素瘤抗体滴度升高，并出现了肿瘤暂时消退。然而，这些患者中只有1例完全消退，治疗后两年仍无疾病。患者的免疫能力与其对免疫治疗的反应之间存在良好的相关性。所有能够被二硝基氯苯或结核菌素致敏且抗体滴度升高四倍的患者对免疫治疗都有一定反应，而无反应性患者对这种治疗无反应。这些研究表明，宿主对恶性黑色素瘤的免疫反应是控制该疾病进展的一个重要因素。因此，免疫治疗可能成为恶性黑色素瘤主要手术治疗的一种有用辅助手段。
