Lymphocyte subsets, lymphocyte reactivity to mitogens, NK cell activity and neutrophil and monocyte phagocytic functions in patients with bladder carcinoma.

OBJECTIVE: Assessment of immunocompetence in bladder transitional cell carcinoma (TCC) patients.

PATIENTS AND METHODS: In 34 untreated patients with bladder TCC, lymphocyte subsets were measured together with lymphocyte reactivity to mitogens, NK cell activity and neutrophil and monocyte phagocytic functions. The data obtained were correlated with both the tumor spread and the grade.

RESULTS: In patients with superficial carcinoma, the proportion of CD4+ cells, the reactivity of lymphocytes to mitogens and NK cell activity was significantly lower than in controls. In patients with invasive disease, the CD4/CD8 ratio, lymphocyte reactivity to mitogens and NK cell activity was significantly diminished when compared with the controls and with patients with superficial carcinoma. Neutrophil and monocyte killing was significantly lower than in controls. Patients with high-grade tumors had a significantly lower CD4/CD8 ratio and lymphocyte reactivity to mitogens than patients with low-grade tumors.

CONCLUSION: These findings indicate gross immunological abnormalities in TCC patients which correlate with stage and grade of tumor.