Thomas R. Hakala

Serum Alpha Fetoprotein and Human Chorionic Gonadotropin in the Diagnosis and Management of Nonseminomatous Germ-Cell Testicular Cancer

Although alpha fetoprotein and human chorionic gonadotropin are present in the serum of some patients with testicular tumors, measurement of these substances has had limited clinical value because the conventional assays are relatively insensitive. With the development of radioimmunoassays for alpha fetoprotein and for the beta-glycoprotein chain of human chorionic gonadotropin, it is possible to detect much lower serum levels of these products. Preliminary reports have suggested that serial determinations of these markers by radioimmunoassay can be useful clinically in patients with nonseminomatous germ-cell testicular tumors.1 , 2 We here describe our 22-month experience with the measurements of alpha fetoprotein and human .xa0.xa0.

Antibody induction of lymphocyte-mediated cytotoxicity against human transitional-cell carcinomas of the urinary tract.

Abstract Serum from a patient with transitional-cell carcinoma of the urinary tract, which induced lymphocyte-mediated cytotoxicity against the carcinoma, was studied to determine the active factor and characterize its mode of action. The active serum factor was an IgG immunoglobulin that induced cytotoxicity only in the presence of effector cells (lymphocytes) and did not require the presence of complement. Contact between the IgG and a tumor-associated antigen appeared to be required before cytotoxicity could be induced in the lymphocyte. The IgG induced lymphocytes from donors with and without transitional-cell carcinoma to become cytotoxic against cells derived from transitional-cell carcinoma of the renal pelvis, ureter, and bladder but not against normal adult or embryonic cells or against renal-cell-carcinoma cells. These characteristics indicate that the active serum factor is a lymphocyte-dependent antibody that is directed against an antigen associated with transitional-cell carcinoma. (N Engl J...

Alpha-Fetoprotein and Human Chorionic Gonadotropin the Management of Testicular Tumors

Alpha-fetoprotein and human chorionic gonadotropin levels were measured by radioimmunoassays in 260 patients with genitourinary diseases, including 93 patients with testicular tumors. Elevations of alpha-fetoprotein and human chorionic gonadotropin were associated only with non-seminomatous germ cell testicular tumors. Our 32-month experience with serial measurements of the 2 markers in patients with these tumors shows that alpha-fetoprotein and human chorionic gonadotropin must be determined and that together they serve as accurate and sensitive indicators of metastases and are helpful in determining the effectiveness of therapy. However, they have limited value in the differential diagnosis of scrotal masses.

Serum induced lymphoid cell mediated cytotoxicity to human transitional cell carcinomas of the genitourinary tract.

In some serums of patients with transitional cell carcinoma (TCC), a factor is present which induces lymphocytes from most donors with or without TCC to become cytotoxic against TCC-derived target cells. The induced cytotoxicity was directed against target cells derived from TCCs of the renal pelvis, ureter, and urinary bladder, but not against cells derived from normal kidney, bladder, testis, or skin or from renal cell carcinoma. Cytotoxicity occurred without complement but did not occur without effector cells.

Changes in Cell-mediated Cytotoxicity during the Clinical Course of Patients with Bladder Carcinoma

The conventional cell-mediated cytotoxicity assay was modified so that more useful estimates of cell-mediated immunity to transitional cell carcimoma of the urinary tract could be obtained. With this modified assay changes in the levels of cell-mediated immunity in transitional cell carcinoma patients to transitional cell carcinoma target cells were measured during the clinical course. Initial results from a small number of patients with invasive and non-invasive tumors showed that anti-transitional cell carcinoma cell-mediated immunity increased after the tumor was removed and during administration of Bacillus Calmette-Guerin.

Lymphocyte Antibody Interaction in Cytotoxicity Against Human Transitional Cell Carcinoma

The interaction of antibodies and lymphocytes in their immune reaction against human transitional cell carcinomas was studied using the in vitro microcytotoxicity assay. A non-complement dependent, IgG antibody was detected in the serum of occasional transitional cell carcinoma patients, which induced cytotoxicity against transitional cell carcinoma target cells by lymphocytes from donors with and without transitional cell carcinoma. The observation that lymphocytes from transitional cell carcinoma donors were more sensitive to activation by this anti-transitional cell carcinoma, lymphocyte dependent antibody is compatible with the hypothesis that the surface of lymphocytes from some transitional cell carcinoma donors is coated in vivo with an anti-transitional cell carcinoma lymphocyte dependent antibody and that this antibody may be a significant factor in immunity to transitional cell carcinomas of the urinary tract.

Immunobiology of genitourinary tumors

Abstract Preliminary studies indicate that cancers of the genitourinary system contain unique tissue-specific tumor associated antigens, and that some patients develop an immune response to these antigens. Additional study will be required before the many nuances of the immunobiology of these tumors are better understood because research in this area is, in fact, just beginning. However, the methodology of tumor immunology is becoming more sophisticated and basic investigation in this area is receiving increased financial support. The practical goals of these research efforts are to develop new immunologic techniques for early detection and treatment. Although immunodiagnosis now appears to be possible for some tumors, further intensive study will be necessary before a rational approach to immunotherapy can be developed for urologic tumors.