Immunoglobulin-producing cells in the inflammatory infiltrates of cutaneous tumors. Immunocytologic identification in situ

Macrophages in Skin Cancer: Quantitative and Functional Studies

The number of tumor-infiltrating macrophages was estimated in 43 patients with skin cancer, including 18 cases of squamous cell and 25 cases of basal cell carcinoma. Macrophages were identified in cell cultures by 2 assays, namely phagocytosis and resistance to detachment by trypsin. The average percentage of adherent cells for the 2 groups of skin tumors was 4.5 ± 2.6 and 10.2 ± 5.2, respectively, and the difference was statistically significant. Follow-up studies after surgical excision of the primary neoplasm showed a relatively low macrophage content in 2 of the 4 cases in which local recurrences occurred. Preliminary functional studies suggested that soluble factors may be released by neoplastic cells, accounting for the inhibitory effect of tumor cell supernatants on macrophage Chemotaxis in vitro.

PGP 9.5 and Cyclin D1 Coexpression in Cutaneous Squamous Cell Carcinomas

Background: squamous cell carcinoma (SCC) consists of altered keratinocytes, presents variable differentiation, inexorably progresses, and on occasion metastasizes. Objective: to investigate the biological activity of epidermal cells in SCCs by estimating the expression of PGP 9.5 and cyclin D1 using immunohistochemistry. Methods: the sample included 13 well-differentiated cases of cutaneous SCC (grade I), 12 moderately differentiated tumors (grade II), and 7 poorly differentiated lesions (grade III). Four cases belonged to the distinct entity of pseudoadenoid SCC. Results: PGP 9.5 expression was positively correlated with tumor stage ( P < .001) and potential perineural invasion ( P < .001), whereas cyclin D1 expression correlated inversely with the degree of cellular differentiation ( P < .001) and PGP 9.5 immunostaining ( P < .001). Conclusion: PGP 9.5 and cyclin D1 coexpression was closely associated with tumor aggressiveness and can be classified as a marker for predicting the outcome of resection-treated skin cancer patients.

Silver-stained nucleolar organizer regions and immunoglobulins in cutaneous squamocellular tumors

This study was conducted to elucidate the biological activity of epidermal cells in cutaneous squamocellular tumors by counting the number of silver-stained nucleolar organizer regions (AgNORs), to estimate the quantity of Ig-producing cells and the inflammatory cellular infiltrate (ICI), and to achieve a comparative evaluation. Twenty cases of actinic keratosis (AK), 20 in situ squamous cell carcinomas (ISC), and 20 invasive squamous cell carcinomas (SCCs) were assessed using a silver colloid technique. Ig-producing or binding cells and ICI were also investigated immunohistochemically. In all samples, AgNORs, Ig-producing cells, and ICI increased in proportion to the degree of malignancy. With regard to AgNORs values, a statistically significant difference was confirmed between AK and ISC (p<0.01), AK and SCC (p<0.001), and ISC and SCC (p<0.05). IgG-producing cells predominated in each case. Furthermore, a linear correlation was detected between ICI and AgNORs in AK and ISC. The significant difference in the number of AgNORs among the 3 stages of involution of SCC reinforces the value of AgNORs as a marker for malignant potential. Despite the absence of a correlation between AgNORs and the proportion of Ig-producing cells, the association between ICI and AgNORs in AK and ISC was obvious.

Silver-stained organizer regions and immunoglobulins in cutaneous keratoacanthomas and squamous cell carcinomas

The aim of this study was to investigate the biologic activity of epidermal cells in keratoacanthomas (KAs) and squamous cell carcinomas (SCCs) by counting the number of silver-stained nucleolar organizer regions (AgNORs), to estimate the quantity of Ig-producing cells and the inflammatory cellular infiltrate (ICI), and to make a comparative evaluation. Thirty KAs (10 at growth stage, 10 at mature stage, and 10 at involution stage) and 28 SCCs (nine well differentiated-Grade 1 (G1), seven moderately differentiated-Grade 2 (G2), five poorly differentiated-Grade 3 (G3), and seven pseudoadenoid) were investigated. The KAs examined had a mean number of 1.727 AgNORs (S.D. 0.232), and IgG predominated in most cases. IgG and IgE increase at the involution, IgA remains at almost the same level, and IgM decreases during the maturity stage. The SCCs examined had a mean number of 2.105 AgNORs (S.D. 0.446). IgG predominated and gradually increased in proportion to the degree of malignancy. There is a significant difference in the number of AgNORs and the proportion of Ig subclasses in contrast to the cellular infiltrate among the three stages of KA. In SCCs, the number of AgNORs and the percentage of Igs and ICI increased gradually in proportion to the degree of malignancy.

Aging, immunity, and tumor susceptibility

The study of aging, susceptibility to tumors, and immunity is at an initial stage, and numerous excellent questions challenge immunologists and tumor biologists. Because unpredicted factors contribute to tumor susceptbility in the human population, the authors feel that the development of an animal model is essential to dissect these complicated issues.

Immune-associated cells in basal cell carcinomas of skin

Increased numbers of mast cells (MCs) and lymphocytes infiltrating in basal cell carcinomas (BCCs) have been observed. The presence of these infiltrating cells has been considered a sign of an immunologic anti-tumor response in the host, but the relationship of these two cell populations has not been examined. To elucidate this possible relationship, 30 non-ulcerated BCCs were analyzed. Frozen sections of the tumors were stained with monoclonal antibodies for Langerhans' cells, lymphocyte subsets and natural killer cells. Fluorescein isothiocynate (FITC)-avidin as well as anti-tryptase and anti-CD45RO monoclonal antibodies were used on formalin-fixed, paraffin-embedded sections for mast cell and T cell identification, respectively. B cells and natural killer cells were rarely observed in these tumors. MCs and T cells were quantified by direct enumeration and expressed as number of cells per high power field (hpf). FITC-avidin and anti-tryptase antibodies were equivalent in their ability to identify MCs. MC content in BCCs ranged from 1.0 to 31 cells/hpf. The number of T cells ranged from 0 to 50 cells/hpf with helper/suppressor cell ratios of 0.2 to 10. There was no correlation between helper/suppressor ratios and mast cell numbers; however, an inverse relationship was observed between the numbers of T cells and the number of mast cells in these tumors. These studies indicate that T cells and MCs are the primary immune cell populations responding to BCCs, and that decreased numbers of T cells are associated with more aggressive tumors.

Biology of basal cell carcinoma (Part II)

Host-tumor relationships involve several factors that can enhance or suppress neoplastic growth. This second part of a review of basal cell carcinoma biology examines the role that hormones, cytokines, local and systemic immunity, congenital and genetic syndromes, and environmental factors play in the development of this neoplasm. Theories of etiology and pathogenesis are discussed, and transplantation and cell culture techniques used to study this cancer are explored. Valuable second-line therapies for treatment of multiple tumors are reviewed, and important areas of present and future research are emphasized.

Immunohistological evaluation of basal cell carcinoma immunoinfiltrate during intralesional treatment with alpha 2-interferon

We investigated the peritumoral and intratumoral immune infiltrate in 6 basal cell carcinomas (BCCs) treated with recombinant alpha 2b-interferon. Each BCC was injected intralesionally three times a week for 3 weeks with 1.5 x 10(6) IU of interferon per injection (total dose 13.5 x 10(6) IU). The immunohistological study was done before the start of interferon therapy and 15 days afterwards, using a series of monoclonal antibodies and an immunocytochemical technique. Before therapy the infiltrate consisted mainly of CD3+ (T) cells, with prevalence of CD4+ (helper/inducer) T cells. The percentage of T cells expressing interleukin-2 receptor (CD25+ cells) was higher in the tumor nests than in the peritumoral infiltrate (20% and 11% respectively). CD1+ (Langerhans) cells and CD14b+ cells (monocytes/macrophages) were present in the peritumoral infiltrate in all cases (9% +/- 5% and 14% +/- 7% respectively). Very few CD56+ (natural killer), CD15+ (granulocytes) and CD20+ (B) cells were observed in the peritumoral infiltrate and none at all in tumor nests. After 15 days of interferon therapy, we observed an increase in peritumoral and intratumoral CD4+ cells. There was a decrease in the number of CD25+ cells and of CD1+ cells in the peritumoral infiltrate. The number of intratumoral CD25+ increased. No variations were seen in CD14b, CD15, CD20, and CD56 positive cells. Eight weeks after completion of therapy, two BCCs were cleared and the remaining four showed clinical and histological improvement. These results may indicate a direct effect of interferon against BCC; in addition the immunohistological findings suggest that intralesional interferon enhances T cell mediated immune response, especially in tumor nests.(ABSTRACT TRUNCATED AT 250 WORDS)

A study of immunoglobulin-containing and other cells in ovine aural squamous cell carcinoma

The peroxidase-antiperoxidase method was used to quantify immunoglobulin (Ig)-containing cells at the host-tumour interface in ovine aural squamous cell carcinoma lesions at various stages of development. IgM-containing cells were never observed; only scattered, but strongly staining, IgA-containing cells were present. IgG-containing cells predominated; their prevalence increased from 0.17 +/- 0.34 cells per high power field (hpf; mean +/- standard deviation) in precursor lesions to a maximum of 13.6 +/- 2.6 cells per hpf in overt tumours which had not metastasized. Their prevalence in overt tumours which had metastasized was 4.6 +/- 3.9 cells per hpf. Quantitation of pyroninophils in sections stained by the methyl green-pyronin method showed a greater prevalence of plasma cells than IgG-containing cells, but a similar pattern of change was apparent. Mast cells were most prevalent in early stages, but no significant change in eosinophil numbers was observed.

Immunoglobulin-producing cells in plasma cell orificial mucositis

Plasma cell orificial mucositis is a benign idiopathic condition of orificial mucous membranes characterized histologically by a dense band-like plasmacytic infiltrate. We studied 8 cases of this disease by immunohistochemical methods for subsets of immunoglobulin-producing cells. The infiltrating plasma cells were found to produce mostly IgG and IgA with the predominance of kappa chain-producing cells over lambda chain-producing cells. This polyclonal plasma cell infiltrate composed of IgG- and IgA-producing cells is in accordance with the pattern observed in the inflammatory infiltrate around certain epidermal neoplasms accompanied by the plasmacytic infiltrate, such as actinic keratosis, Bowen's disease, squamous cell carcinoma, and syringocystadenoma papilliferum.

An absence of human leukocyte antigen-DR and a decreased expression of beta 2-microglobulin on tumor cells of basal cell carcinoma: no influence on the peritumoral immune infiltrate

The expression of human leukocyte antigen-DR (HLA-DR) and beta 2-microglobulin on the tumor cells and their correlation (if any) to the degree and the composition of the peritumoral mononuclear infiltrate were studied in 37 basal cell carcinomas from 32 patients with an indirect immunoperoxidase technique. In 36 of 37 basal cell carcinomas (97%) there was no expression of HLA-DR on tumor cells of basal cell carcinoma. In 13 of 37 basal cell carcinomas (35%) beta 2-microglobulin was expressed on the tumor cells. Both a diffuse cytoplasmic and a membrane staining were observed in only six of these 13 basal a diffuse cytoplasmic and a membrane staining were observed in only six of these 13 basal cell carcinomas; in the other seven basal cell carcinomas only a diffuse cytoplasmic staining was observed. In all 37 basal cell carcinomas there was membrane staining for beta 2-microglobulin in the normal epidermis. The intensity of staining in the normal epidermis was always stronger than that in the tumor nests. There was a varying degree of peritumoral immune infiltrate in all basal cell carcinomas. It comprised mainly T cells (mean percentage 57 +/- 15). In the group of patients with basal cell carcinoma with moderate to heavy infiltrate the mean percentage of T cells was 63 +/- 13, which was significantly higher than the mean percentage of T cells (46% +/- 14%) in the group of patients with basal cell carcinoma with a mild infiltrate. This difference was mainly the result of an increase in T helper cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Routine diagnostic immunohistochemical labeling of extracellular antigens in formol saline solution-fixed, paraffin-embedded cutaneous tissue

A technique involving modification of the routine paraffin embedding procedure that allows immunohistochemical examination of extracellular antigens by light microscopy is described. The method is thus suitable for routine diagnostic immunofluorescence studies, permitting reliable, reproducible immunolabeling of immunoglobulins and complement components usually not preserved by routine processing procedures. Immunoreactivity as measured by direct immunofluorescence and immunoenzymatic (peroxidase-antiperoxidase) histochemistry is comparable to results with fresh-frozen cryostat sections. Morphologic preservation is superior, however, and the processed material is suitable for routine hematoxylin-eosin staining.

Characterization of the mononuclear infiltrate in basal cell carcinoma: a predominantly T cell-mediated immune response with minor participation of Leu-7+ (natural killer) cells and Leu-14+ (B) cells

We investigated the peritumoral inflammatory infiltrate in 22 basal cell carcinoma (BCC) from 18 patients using a series of monoclonal antibodies. In all the 22 BCC the infiltrate consisted mainly of T cells (55 +/- 15%) and only in three cases an invasion of the tumor nests by these cells was observed. The T helper (TH) subset predominated over the T suppressor/cytotoxic (TS/C) subset (TH/TS/C ratio of 1.9 +/- 0.8). In 8 of 22 BCC mild infiltrate was observed with 48 +/- 13% T cells and a TH/TS/C ratio of 1.5 +/- 0.6. In 14 of 22 BCC moderate to heavy infiltrate with 59 +/- 15% T cells and a TH/TS/C ratio of 2.0 +/- 1.0 was observed. There was a significant difference in the percentage of T cells in BCC with moderate to heavy infiltrate and that in BCC with mild infiltration. The mean percentage of HLA-DR+ cells was 54 +/- 11%; Langerhans cells (LC) 4 +/- 5%; and Leu-M5+ (monocytes and macrophages) 16 +/- 11%. Less than 2% Leu-14+(B) cells were seen in the infiltrate. The mean percentage of Leu-7+ (natural killer) cells was 4 +/- 4%, and only 1 of 22 BCC Leu-7+ cells invaded tumor nests, contacting with tumor cells. From these results we concluded that T cells play a major role in the defence against BCC proliferation. The main role of Langerhans cells and Leu-M5+ cells may be that of antigen presentation. B cells and NK cells probably play a minor role in the local defence against BCC proliferation.

Monoclonal antibody labeling of mononuclear cell surface antigens in formaldehyde-fixed paraffin-embedded cutaneous tissue

The influence of the sequential stages of conventional formaldehyde fixation and paraffin embedding of cutaneous tissue on monoclonal antibody labeling of cell surface antigens is described. The effects of variation in fixation time, dehydration, clearing, wax embedding, and enzyme treatment of cutaneous sections were examined. By curtailing fixation time, using cold ethanol dehydration, and limited cold clearing with xylene, immunoreactivity of several important monoclonal antibodies was retained. Wax embedding could be achieved at 58 degrees C for 1 h or by using low-melting-point wax at 42 degrees C for 3 h. Thus was derived an optimal processing procedure which afforded good tissue morphology and allowed reliable reproducible labeling by monoclonal antibodies to cell surface antigens.

Immunoenzymatic typing of lymphoplasmacytoid skin infiltrates

Monoclonal immunoglobulin-producing lymphomas (immunocytomas, plasmacytomas, and immunoblastomas) constitute 15 to 20% of all cutaneous lymphomas. Their differentiation from polymorphous lymphoplasmacytoid inflammatory or pseudolymphomatous infiltrates may be difficult if sections are stained for a single light chain only. It was the aim of the study to elucidate the ratio of the kappa- to lambda-positive cells in 10 lymphoproliferative, 5 pseudolymphomatous, and 42 inflammatory lymphoplasmacytoid cutaneous infiltrates and to characterize them by the type of Ig (alpha, gamma, mu, kappa, or lambda) synthesized intracellularly. An indirect immunoenzymatic double-labeling method (alkaline phosphatase and peroxidase) was used for the simultaneous demonstration of kappa and lambda light chains and alpha, gamma, and mu heavy chains in paraffin sections. Ig-producing lymphomas of the skin show patchy monoclonal proliferations of cells synthesizing kappa IgM in almost 50% of the cases (5 of 10). Monoclonality is claimed if the ratio of lambda- to kappa-positive cells is at least 1:10, or vice versa. In polyclonal inflammatory and pseudolymphomatous infiltrates, the lambda/kappa ratio never exceeds 1:5. The most common cell type found in these reactive infiltrates produces gamma heavy chain; some produce alpha chain, but only a few produce mu chain. In high-grade malignant lymphomas, the tumor cells may lose their capacity for Ig production.

The biology of basal cell carcinoma: a review

Features of basal cell carcinoma are reviewed within the broad categories of growth characteristics, histogenesis, ultrastructural features, biochemical properties, site of origin, metastatic potential, and immunobiology. Biologic features that pertain to host-tumor interactions are emphasized. Perhaps a better understanding of these host-tumor relationships will offer more effective methods of treating and preventing these neoplasms in the future.

Subpopulation of lymphocytes in the infiltrate of experimental sporotrichosis

Lymphocyte subpopulations of dermal infiltrated cells on experimental sporotrichosis of guinea pigs was performed. According to Tan's method, infected sites were incubated with collagenase and then mechanically disaggregated. The liberated cells were used for determination of lymphocytes subpopulation. The predominance of B cells was present on the inoculated site, compare with blood from control and inoculated animals. Thus, the present result suggests the important role of humoral immunity in the development of sporotrichosis lesion.

Relationship between T and B lymphocyte values and prognosis in malignant melanoma

T and B lymphocyte populations were evaluated in 56 patients with malignant melanoma. Active rosettes (T-Ea) were decreased only in metastatic patients, while the total T population (T-Et) was decreased in all stages. In addition the metastatic patients presented significant decreases in IgD and IgM subpopulations. An increase in null cells was noted in metastatic patients. Regular controls over a period of 2 years showed that T-Ea levels were closely linked to the clinical picture. Patients whose values were constant remained cancer free, while a reduction heralded the appearance of clinical and/or radiological signs of metastasis.