MYOCUTANEOUS FLAPS IN PATIENTS WITH HEAD AND NECK-CANCER RETAIN THEIRIMMUNOLOGICAL CAPACITIES IN AN ACTIVATED FUNCTIONAL-STATE

Free/pedicled myocutaneous flaps used as functional replacement after radical dissection of advanced stage squamous cell carcinomas of the o ral cavity/oropharynx were examined by immunohistochemistry (APAAP-tec hnique). Biopsies from eight patients were taken at the time of surger y and at 3 and 5 months postoperatively. Fifteen monoclonal antibodies were used to detect surface antigens as markers of phenotypic changes of immune competent cells. In post-operative biopsies all antigens in vestigated increased significantly. Significantly higher numbers of CD 45RO+ (P<0.01) and CD45RA+ (P<0.001) leukocytes were detectable. The m ajority of these leukocytes were TcR alpha/beta+/CD3+ T-cells, which i ncreased in the CD4 (P<0.05) and the CD8 (P<0.001) subset. In addition , B-cells (P<0.05), granulocytes (P<0.05), NK cells (CD16+ lymphocytic cells; P<0.05) and mature macrophages (25F9+cells; P<0.01) were incre ased. Intra- and subepidermally a significantly (P<0.01) higher number of dendritic-/Langerhans cells (CD1a+) was detectable. In post-operat ive biopsies, the activation-associated antigens ICAM-1, VCAM and HLA- DR were expressed on significantly more mononuclear-/endothelial cells and on keratinocytes. Our findings indicate that the myocutaneous fla ps still contained cells with immunological capacities.