Autoantibodies In Malignant Diseases

The association between neoplastic diseases and autoimmune conditions led investigators to search for autoantibodies in cancer patients who did not necessarily develop overt autoimmune manifestations. Indeed, various autoantibodies have been detected in sera of patients with both hematologic and epithelial malignancies [32].

4. ANTINUCLEAR ANTIBODIES [33-45]

There are many reports of antinuclear antibodies in the sera of patients with malignant tumors. Burn-ham [33] found positive ANF tests in 65 (19%) of 342 patients with neoplastic disease, compared with a frequency of 1% in the controls. In another series including 113 cancer patients, the incidence of positive ANA test was 27% compared with 2% in the control group [34]. Likewise, Zermosky et al. [35] found positive ANF test in 13% of patients with various malignancies. Increased prevalence of ANA was reported in epithelial tumors including carcinoma of the breast, prostate, melanoma, hepatocellular carcinoma and leukemias [35-42], The antinuclear antibodies produced in malignancies differ from those that characterize SLE. In SLE the antinuclear antibodies are typically directed against many nuclear antigens including ssDNA, dsDNA, Sm and RNP. However, in malignancies the spectrum of antinuclear antibodies described is more limited; for example in one study of patients with lymphomas and leukemias only anti-ssDNA antibodies were described. We studied 84 patients with Hodgkin's lymphoma and 55 with non-Hodgkin's lymphomas for the presence of autoantibodies to ssDNA, dsDNA, Poly (I), Poly (G), cardiolipin, histones, RNP, Sm, Ro, La and the common anti-DNA idiotype (16/6), using an ELISA assay [45]. Anti-ssDNA antibodies were detected in the sera of 23.8% of the patients with lymphomas. Anti-RNP and anti-Sm antibodies were found in 21.7% and 20% of the patients respectively, significantly more than in the controls. With all other autoantibodies examined no significant difference could be observed in the incidence between lymphoma patients and controls. The prognostic significance of increased ANA was examined in breast cancer and the results have shown that the presence of ANA in the serum of these patients prior to mastectomy was associated with higher risk of recurrence or metastases in a follow-up of 2 years [37]. In another study, the presence of ANA in the serum of patients with breast cancer was found to be a poor prognostic factor [36].

5. RHEUMATOID FACTOR [46-51 ]

Rheumatoid factors (RF) are autoantibodies directed against antigenic sites on the Fc portion of IgG and are one of the serological markers of rheumatoid arthritis. RF was reported in various autoimmune diseases and was found to be increased in several malignancies as well. The incidence varies according to different workers between 11 and 85% [49]. Similar to ANA, the presence of RF was also found to correlate with poor prognosis in transitional cell carcinoma of the bladder [49], melanoma and gastrointestinal cancer [48],

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