Characterization of peripheral blood and ovarian cancer-infiltrating lymphocytes: effect of HIV infection on phenotypic expression and proliferative response.

A study that focused on the identification of the phenotype and proliferative responses of peripheral blood and ovarian cancer-infiltrating lymphocytes in a patient with stage III ovarian cancer who had human immunodeficiency virus infection is presented. Monoclonal antibodies and flow cytometry were used to determine the phenotypic expression, while thymidine incorporation response to stimulation by phytohemagglutinin and concanavalin A was used to determine the proliferative response. These immunologic characteristics were compared with the results of similar analyses performed in four HIV-seronegative patients with stage III ovarian cancer. The CD4:CD8 ratio in peripheral blood and ovarian tumor in the HIV-seropositive patient was 0.43:1 and 0.46:1, respectively, while in the four seronegative patients it was 1.83:1 and 0.64:1, respectively. The absolute and mean CD4 counts in the peripheral blood in the HIV-seropositive patient and HIV-seronegative patients was 260/mm3 and 707/mm3 (611-743), respectively, while in the ovarian tumor the percentage distribution of CD4 was 13 and 21% (9-44%), respectively. Despite there being intratumor immunosuppression in all five cases, the proliferative response was most markedly suppressed in the HIV-seropositive patient. Although surgery and chemotherapy were well tolerated, the HIV-seropositive patient died 6 months later with rapidly progressive disease. The remaining four HIV-seronegative patients are all alive, between 9 and 14 months postoperatively.