Microinvasive squamous cell carcinoma of the vagina.

Two cases of microinvasive squamous cell carcinoma of the vagina are reported. Similar to their counterparts on the uterine cervix, intraepithelial lesions and microinvasive and invasive carcinoma of the vagina are probably different points in the continuum of a single disease process. It is recommended that patients with vulvar, vaginal, and cervical squamous lesions be followed closely for development of vaginal invasive lesions.

Gastric perforation: a late complication of abdominal radiation for para-aortic lymph node metastasis from cervical squamous carcinoma.

Gastric perforation was found at laparotomy for acute abdominal pain in a woman treated with pelvic and abdominal radiation for squamous cell carcinoma of the uterine cervix metastatic to the para-aortic nodes. This case may provide additional evidence suggesting that risks involved in para-aortic radiation may outweigh the benefits.

Inhibition of leukocyte adherence by potassium chloride extract of allogeneic squamous cell carcinoma of the human uterine cervix.

Leukocyte adherence inhibition (LAI) assay was used to evaluate cell-mediated immunity in patients with invasive squamous cell carcinoma of the cervix. The reactivity of the peripheral blood leukocytes of these patients was evaluated after incubation with pooled extracts of allogeneic squamous cell carcinoma of the cervix. One hundred sixty-seven sets of LAI assays were performed on 54 individuals, including 23 patients with Stage I squamous cell carcinoma of the cervix, 9 patients with other stages of this tumor, 9 patients with unrelated tumors and 13 normal healthy volunteers. A protein concentration of one milligram per milliliter in the tumor extract and 10% fetal bovine serum in the feeding media gave the best results. Eighty-seven percent (28/32) of patients with squamous cell carcinoma of the cervix showed marked specific reactivity. No difference was found in the LAI indices of different stages of the disease.

Sequential in vitro reactivity of lymphocytes from patients with cervical squamous malignancy in a cytotoxicity assay.

The in vitro reactivity of peripheral blood lymphocytes from patients with cervical squamous malignancy was prospectively followed over a relatively long period of time. In 12 of 14 patients with preinvasive cervical lesions, reactivity was present at the time of initial diagnosis. Three months after treatment, reactivity was still present in only one of 12 (8%). Six months after the treatment, no significantly reactivity could be detected in any of them. In the group with invasive squamous cell carcinoma, four patients developed recurrence in the course of follow-up. Reactivity was present in all at the time of initial diagnosis. In three of them, cytotoxic reactivity was retained up to the time of death, in spite of clinical deterioration. One lost the reactivity after the third course of chemotherapy. Fourteen patients with invasive squamous cell carcinoma were followed up to 24 months without any evidence of recurrence. In all of this group, the cell-mediated cytotoxicity was nonreactive at 9 months. We conclude that: (1) patients with squamous cell carcinoma of the cervix demonstrated cell-mediated immune responses which disappeared 3 to 9 months after effective treatment (apparent cure) and (2) with persistent disease, in spite of marked clinical deterioration and inanition, cell-mediated cytotoxicity was demonstrable until the time of death.

Partial characterization of serum suppressor factors in patients with cervical squamous carcinoma.

A cell-mediated cytotoxicity system was used to characterize the suppressor factors in sera from patients with invasive squamous cell carcinoma of the uterine cervix. The immunoglobulin-M fraction of the sera of 17 patients with different stages of invasive squamous cell carcinoma of the cervix, separated by Sephadex gel filtration, were tested. All showed marked cytotoxic suppressor activity, including two cases in which sera showed only mild activity. The immunoglobulin-G fraction of sera from 13 patients with invasive squamous cell carcinoma of the cervix was separated by ion exchange chromatography. The cytotoxic suppressor activity of the immunoglobulin-G fraction proved to be comparable in effect to that of the whole sera. By using increasing dilutions of IgG and IgM fractions, it could be demonstrated that IgM fraction retained its activity at 0.01 +/- 0.005 mg/ml whereas IgG fraction was devoid of activity at this concentration, suggesting that these two immunoglobulin fractions act independently. It is suggested that the cytotoxic suppressor activity in sera from patients with invasive squamous cell carcinoma of the cervix resides in the gamma globulin fraction and that both immunoglobulin-M and immunoglobulin-G of their sera manifest the cytotoxic suppressor activity independently. (Am J Reprod Immunol. 2:199-203.)

Cytotoxic blocking activity in invasive squamous cell carcinoma of the human uterine cervix.

A cell-mediated cytotoxicity assay was used to evaluate the specific reactivity of patients with squamous cell carcinoma to an established cell line derived from squamous cell carcinoma of the cervix. Heat inactivated sera from patients with squamous cell carcinoma could very effectively nullify this specific cytotoxicity (P less than 0.01). There was no significant difference between the cytotoxic blocking activity of the sera from patients with different stages of the cancer in this experimental setup.

Cell-mediated cytotoxicity in preinvasive and invasive squamous cell carcinoma of the cervix.

Cell-mediated immunity was tested by coincubation of target cell line (2043) of human squamous cell carcinoma and peripheral blood leukocytes (PBL) of 22 patients with squamous cell neoplasia of the uterine cervix, 9 patients with other tumors, and 9 normal females. The percentage of cell reduction in mild dysplasia was 90.1 +/- 6.8% (.001 less than P less than .005), in moderate dysplasia was 91.1 +/- 6.4% (.001 less than P less than .005), in severe dysplasia was 91.6 +/- 15.6% (P less than .001), in carcinoma in situ was 85.0 +/ 2.6% (P less than .001), and in invasive squamous cell carcinoma of the cervix was 85.0 +/- 6.9% (P less than .001). Peripheral blood leukocytes of patients with squamous neoplasia did not show any significant cytocoxicity against cell line SKOV-3, developed from an ovarian adenocarcinoma, nor did the PBL of patients with "other tumors" show any significant cytotoxicity against cell line 2043. This study shows that even in early stages of preinvasive squamous cell carcinoma of the cervix, the PBL are sensitized against the neoplastic process, confirming that different stages of cervical intraepithelial neoplasia and invasive squamous cell carcinoma are different intensities of the same biologic process.