DISEASE PROGRESSION AND IGA-ANTI-FAB- F(A B')(2) AUTOANTIBODIES IN PATIENTS WITH HEAD AND NECK-CANCER/

Background: Patients with malignant tumors of the head and neck often show immune defects. Increased serum IgA levels have been reported in these groups of patients. We investigated whether IgA-anti-Fab or IgA- anti-F(ab')(2) autoantibodies, which have been shown to correlate with severe dysfunction of the immune system, also appear in patients with head and neck cancer. Patients: Sera of 110 patients with squamous ce ll carcinoma, eight patients with adenoid cystic carcinoma, and 57 hea lthy controls were tested with an ELISA for IgA-anti-Fab autoantibody activity. Results: Patients with head and neck cancer showed a higher IgA-anti-Fab activity (OD: 399, n = 118) than healthy controls (OD: 84 , n = 57, p < 0.0001). An association between stage of disease and IgA -anti-Fab activity could be established in patients with SCCHN. Stage IV patients had a significantly higher IgA-anti-Fab activity (OD: 538, n = 51) than stage I patients (OD: 283, n = 18, p < 0.05). Patients w ith stage II (OD: 293, n = 13) or stage III (OD: 379, n = 28) showed i ntermediate activity. Also a higher IgA-anti-Fab activity than in heal thy controls was demonstrated in the eight patients with ACCHN (OD: 31 4, n = 8, p < 0.01). The highest IgA-anti-Fab activity was observed in eight patients with SCCHN who died within six months after testing (O D: 1004, n = 8). Similar results were obtained for IgA-anti-F(ab')(2) autoantibodies. Our findings suggest an association between autoimmuni ty and final desintegration of physiological body functions. Conclusio n: The occurrence of IgA-anti-Fab/IgA-anti-F(ab')(2) autoantibodies mi ght be interpreted as an aspect of immune deficiency in patients with malignant tumors of the head and neck.