DIFFERENCES IN IMMUNE STATUS BETWEEN WELL-NOURISHED AND MALNOURISHED HEAD AND NECK-CANCER PATIENTS

Malnutrition is reported to occur in approximately 30% of head and nec k cancer patients. Also, impaired immunocompetence is described as a c ommon phenomenon in this patient group. The purpose of this study was to assess the possible relationship between malnutrition and some prog nostically important immune parameters in head and neck cancer patient s. Thirty-two malnourished (recent weight loss greater than or equal t o 10%) and 34 well-nourished patients undergoing curative treatment fo r advanced head and neck cancer were studied prospectively, and six pa ra meters of their immune status (leucocytes, lymphocytes, lymphocyte phenotyping, monocytes, HLA-DR expression on monocytes and serum inter leukin-10) were determined on the day of panendoscopy. Reference value s for monocytes, HLA-DR expression and interleukin-10 were obtained fr om 43 healthy controls. Although the number of monocytes was elevated in both patient groups, the HLA-DR expression on these monocytes was s ignificantly lower in the malnourished than in the well-nourished and control groups. Tumor stage, tumor localization, recurrence after init ial radiotherapy, age and gender were not correlated to HLA-DR express ion. No relationships emerged between nutritional status and lymphocyt e subsets. Malnourished head and neck cancer patients show a significa ntly lower HLA-DR expression on monocytes than well-nourished ones and healthy controls. According to the literature this would imply an inc reased risk for postoperative complications. Indeed, postoperative com plications occur more frequently in malnourished than in well-nourishe d patients.