A comparison of tube leukocyte adherence inhibition assay and standard physical methods for diagnosing colorectal cancer.

Abstract

In vitro antitumor immunity, measured by means of a tube leukocyte adherence inhibition (LAI) assay, was able to demonstrate early colorectal cancer in cases yet undiagnosed. Testing 106 patients attending a colonoscopy clinic, we found that nine of 15 (60%) patients with colorectal cancer were LAI-positive. The nine included: five of six with Dukes' A and B; one of two with Dukes' C; and three of seven with Dukes' D lesions. Of 58 patients without colon neoplasia, one had a positive test. By contrast, barium enema results were diagnostic for 13 of 15 (87%) cases and colonoscopy for 11 of 15 (73%). There were 32 colon polyps discovered by means of barium enema and colonoscopy. Of 13 adenomas removed, four had stimulated positive LAI responses. Of another 19 polyps not removed two incited positive LAI responses. Two patients with histories of recurrent adenomas were LAI-positive, though only one had a new polyp that could be detected by means of barium enema. For a procedure to be of diagnostic value for a given disease, sensitivity and specificity must be at least 1.0. If this sum is 2.0, the test is ideal. The sum of sensitivity and specificity for the tube LAI assay, barium enema, and colonoscopy were 1.58, 1.87, and 1.73, respectively, for colorectal cancer; 1.81, 2.0, and 2.0, respectively, for early colorectal cancer; and 1.42, 1.77, and 1.55 respectively, for advanced colorectal cancer. In this limited series of patients, the barium enema seems to be superior to the tube LAI assay for diagnosing colorectal cancer, but the difference in sensitivity and specificity is not statistically valid by the paired chi square test. The results of this study shows conclusively, that the tube LAI is of diagnostic value and suggest its use for evaluating suspected cases, especially early ones, of colorectal cancer.