Clinical evaluation of the Makari tumour skin test.

A double-blind evaluation of the Makari intradermal test has been carried out over a 3 year period. The test is based upon the measurement of the local erythematous reactions of the skin to a series of intradermal injections of cancer-derived antigens which have been preincubated with the patient's serum. These antigens have been prepared from human tumour material by the application of major physical and chemical degradative procedures. The patients examined consisted of 584 patients referred to King's College Hospital, the majority of whom had signs and symptoms which suggested the presence of malignant disease. Our studies have confirmed that positive intradermal tests are seen in many but not all patients with malignant tumours arising in different organs, including those of the digestive, respiratory and genitourinary systems. In subjects with carcinoma the response to the test was related to the stage of the carcinomatous process, the largest proportion of positive tests occurring in patients with early disease. An appreciable proportion of positive test results were also observed in diseases associated with inflammatory and reactive processes. In practical terms, therefore, the test is not in its present form suitable for routine cancer screening. However, the relatively high percentage of positive tests in early carcinoma indicates a possible role in monitoring the patient's response to treatment, in detecting the recurrence of tumour at an early stage and in differential diagnosis.