[The immunologic tumor diagnosis]

Abstract

Issuing from a possibility of classification of tumour-associated antigens (TAA), corresponding to themodern state of recognition, the present situation of the immunological tumour diagnostics is discussed. The direct proof of tumour-associated antigens in the blood or in other body fluids, as one of the fundamental possibilities, is hitherto practically matured only for the alpha-fetoprotein and in this case only contribute to the diagnostics of liver carcinomas and malignant teratoblastomas. The determination of the carcinoembryonal antigen (CEA) in the serum or plasm has at present no essential diagnostic significance, may however, be used for the control of the therapeutic effect of cancer of the colon, rectum as well as the stomach. It is reserved for prospective studies to estimate the valency of the determination of CEA or fetal sulphoglycoproteid antigen in the gastric juice for the recognition of early carcinomas of the stomach. At present the proof of an immune response of the tumor carrier to TAA in vitro seems to be more favourable as a second way of the immunological tumour diagnostics. Sensitivity as well as specificity might here at first higher be estimated, when they are theoretically established. Whereas the inhibition test of leucocyte migration and technically similar variants in apparently sufficient specifity have an insufficient sensitivity and thus give too many falsely negative results the mobility test of the electrophoresis of macrophages in the modification of the immunological tumour profile distinguishes itself by a high certainty and by evidence on the probable localisation of the organ and the primary tumour (up to now verified for the cancer of colon and rectum, carcinomas of the stomach). Apart from the research of further principles, however, even for this test technological simplifications are to be found, before a broader use in routine work becomes practicable.