Robinson J C
Surg Gynecol Obstet. 1981 Dec;153(6):909-21.
There are definite immunologic abnormalities associated with the cancer bearing state which are apparent on both in vitro and in vivo testing. The weight of evidence presented suggests an increasing loss of immunocompetence with increasing disease stage and a degree of positive correlation of immunologic responsiveness with prognosis. Unfortunately the correlation is not absolute for any one individual, although it is often fairly well defined for a large group of patients. This is a failure of all other prognostic studies as well. The critical question as to whether or not this loss of immune integrity reported represents a cause or a result of cancer progression remains largely unanswered. The data suggests that the measured impairment of immunologic responsiveness stems from conditions brought about by the tumor bearing state. Regardless of which precedes the other, the cancer or the immunoincompetence, the additional question as to the effect of immune impairment on the disease progression also remains uncertain. Results of tests to monitor immunocompetence appear to be of some value if used as additional data on which to base prognostic conclusions. Dinitrochlorobenzene skin testing is an assay that is easily performed and probably yields the most easily obtained significant prognostic information.
存在与荷癌状态相关的明确免疫异常，这在体外和体内检测中均很明显。所呈现的证据表明，随着疾病阶段的增加，免疫能力逐渐丧失，且免疫反应性与预后呈一定程度的正相关。不幸的是，尽管对于一大群患者来说这种相关性通常相当明确，但对于任何一个个体而言，这种相关性都不是绝对的。这也是所有其他预后研究的不足之处。关于所报道的免疫完整性丧失是癌症进展的原因还是结果这一关键问题，在很大程度上仍未得到解答。数据表明，所测得的免疫反应性损害源于荷瘤状态所带来的状况。无论癌症和免疫功能不全哪个先出现，免疫损害对疾病进展的影响这一额外问题也仍不确定。如果将监测免疫能力的检测结果用作得出预后结论的额外数据，似乎具有一定价值。二硝基氯苯皮肤试验是一种易于进行的检测方法，可能会产生最容易获得的重要预后信息。
