Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 45520

AbstractMaterial and MethodsResultsDiscussionReferencesTable and Figures
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2007 | Month : April | Volume : 1 | Issue : 2 | Page : 50 - 54

Evaluation Of The Cellular Immune Response In Patients With Head And Neck Cancer

GODEKMERDAN A ,KAYGUSUZ I ,SAKALLIOGLU O, ILHAN F,DEMIR N

Firat University Medical Faculty Dept. of Immunology and Firat University Medical Faculty Dept. of ENT Diseases

Correspondence Address :
Fulya ILHAN MD PhD
Firat University Department of Immunology.
Phone:+90 424 2333555/2166, Email: fulhan23@yahoo.

Abstract


Aim: The aim of the present study is to evaluate the cellular immune response in patients with head and neck cancer.
Material-Method: Twenty volunteer healthy subjects as controls and 34 patients who have been diagnosed with squamous cell carcinoma at the Department of Ear Nose Throat in Firat University Firat Medical Center from June 2002 to January 2005 were included in the study. The ages of the patients ranged between 27 and 74 years (mean 56.8+/-10.3), and the ages of the controls ranged from 21 to 69 years (mean 53.4+/-12.7). There were squamous cell carcinoma (SCC) of larynx in 30 patients, SCC of hypo pharynx in three patients, and SCC of paranasal sinus in one patient. 18 of these patients were in the early stage, four patients in the advanced stage, and 14 patients in the metastatic stage. Histopathological diagnoses were carried out by biopsies in preoperative term and pathological examination of the specimens in postoperative term. The examination of lymphocyte sub groups was done by flow-cytometiric analysis.
Results: In the flow cytometry of peripheral blood samples of head and neck cancer patients and controls, while the ratio of CD4+/CD8+ T cell significantly decreased, the ratio of B lymphocyte, NK cell and activated Tc cell increased in patients compared to the controls. When the patients were compared to each other, CD4+25+ cells were in high level in metastatic patients in comparison to patients in early stages.
Conclusion: These results indicated that especially cellular immune response was activated in head and neck cancer, but it was not enough to prevent the cancer

Keywords

Immune response, head and neck cancer


Decrease in immunity in patients with cancer generally involved the alteration of immune competent cells in circulation. Cellular immunity plays an important role in controlling tumours. T-lymphocytes take on the main role in immune response against the tumours (1). In general, the deterioration of T-cell functions and the insufficiency of immune response against the tumour are valid in patients with cancer. The other reason of decreased immunity in these patients is the alteration of immune competent cells in circulation (2),(3),(4),(5). The immune system plays an important role in tumour growth and regression. The tumours may develop more frequently when the immune system is less active (5). Many tumours have lymphoid infiltrates. The immune system can limit the spread of tumours with different mechanisms. The aim of this study is to evaluate the cellular immune response in patients with head and neck cancer.

Material and Methods


Twenty volunteer healthy people as control and 34 patients with diagnoses of squamous cell carcinoma at the Department of Ear Nose Throat in Firat University Firat Medicine Center from June 2002 to January 2005 were included in this study. The ages of patients ranged from 27 to 74 years (mean 56.8+/-10.3), and the ages of controls ranged from 21 to 69 years (mean 53.4+/-12.7). There were squamous cell carcinoma (SCC) of larynx in 30 patients, SCC of hypopharynx in three patients, and SCC of paranasal sinus in one patient. Sixteen of these patients were in the early stage, four patients in the advanced stage, and 14 patients in the metastatic stage.

Histopathology:
Histopathological diagnosis was carried out by biopsy material in pre- and post-operatively. Analysis by flow cytometry: The examination of lymphocyte subgroups was done by flow-cytometric analysis. For immunophenotypic analysis, 2 ml of peripheral blood samples were collected in glass tubes containing ethylenediaminetetraacetic acid (EDTA) and analyzed within one hour of collection. Lymphocyte (CD3+, CD4+, CD8+, CD19+, CD23+, CD25+, CD26+, and CD30+) cell rates were calculated by using flow cytometry conducted on a Coulter EPICS XL–MCL (Beckman Coulter, USA) using fluorescence-labelled (FITC or PE) monoclonal antibodies (Coulter Immunotech, France). Erythrocytes were removed from the peripheral blood sample in the EDTA tube by using the whole blood lysis method. Following erythrocyte removal, 5000 cells were counted in the appropriate gate for each tube and analyzed. Lymphocytes reacting with each monoclonal antibody were separated according to their fluorescence properties and their numbers reported as percentage.

Statistical analysis:
All the statistics were performed in SPSS version 10.01 software (SPSS, Inc., Chicago, IL, USA). Data were analyzed by using Independent- Samples t test, One Way analyses of ANOVA, and Tukey’s HSD test as needed. p <0.05 was considered to be significant.

Results

In the flow cytometry of peripheral blood samples of cancer patients and controls, while the ratio of the CD4+/CD8+ T cell significantly decreased, the ratio of B-lymphocyte, NK cell, and activated Tc cell increased in patients compared to controls (Table/Fig 1). When the patients were compared to each other, CD4+25+ cells were observed to be in high level in patients with metastasis compared to patients in early stages (Table/Fig 2).

Discussion


The effector mechanisms of both cell-mediated immunity and humoral immunity have been shown to kill tumour cells in vitro (6). The T-cell response is unquestionably the most important host response for the control of growth of antigenic tumour cells. It is responsible for both the direct killing of tumour cells and the activation of other components of the immune system. T-cell immunity to tumours reflects the function of the two T-cell subsets: class II-restricted T cells that largely represent CD4 helper T (TH) cells that mediate their effect by direct interaction with antigen-presenting cells (APC) and by the secretion of lymphokines to activate other effector cells and induce inflammatory responses and class I-restricted T cells that largely represent CD8+ cytotoxic T (Tc) cells that can also secrete lymphokines but mediate their effect mostly by direct lyses of tumour cells (7).
Cardi et al. (8) observed that lymphocytes extracted from subcutaneous metastasis were characterized by a significantly reduced ratio of CD4+ to CD8+ T cells as compared to peripheral blood lymphocytes from the same patients.
Gonzalez et al. (9) studied the functional response and phenotypic characterization of peripheral blood T-cells and their correlation with the clinical stage of disease in 29 males with previously untreated carcinoma of the larynx and 24 healthy male controls. Peripheral blood T cells, phenotypically CD2+, CD3+, were significantly decreased in patients relative to the controls. Mandel-Brown et al (10) reported that quantification of the T-lymphocyte subpopulation in peripheral blood did not indicate the presence of metastatic diseases. Significantly higher CD4/ CD8 ratio was present in lymph nodes containing metastatic disease compared to lymph nodes without metastatic disease.
Kuss et al.(11) determined a significantly lower absolute number of CD3+, CD4+, and CD8+ T cells in patients with head and neck squamous cell carcinoma (HNSCC) compared to normal controls (NC). However, no differences in the percentages of T-cell subsets between patients and NC were observed.
In the present study, we found a lower CD4/CD8 ratio in the study group. These findings indicate that increased CD8+ T lymphocytes (Tc) ratio has an important role in immunity developed against cancer.
NK cells can kill a wide range of tumour targets in vitro (7), especially cells that have reduced class I MHC expression and can escape killing by Tc (6). NK cells play a role in host defense against growth of tumour cells at both primary and metastatic sites (7).
Mickel et al. (12) evaluated peripheral blood lymphocyte and lymph node lymphocyte natural killer (NK) cell activity in 22 patients with head and neck squamous cell carcinoma. The peripheral blood lymphocyte NK activity of cancer patients was significantly less than controls.
Kou and Oi (13) indicated that the NK cell's activity in patients with laryngocarcinoma was lower than both the normal control group and the polyp of vocal cord patients group. They found that the more severe was the degree of disease, the lower the activity of the NK cell.
According to our result, the percentage of NK cells was higher (p<0.05). However, there is no difference in NK cells among early, advanced, and metastatic stage patients. B-lymphocytes have a potential role on tumour immunity producing tumour-reactive antibodies. Antibodies may mediate tumour cell lyses by both complement fixing and antibody dependent cellular cytotoxicity (ADCC). ADCC is a more potent lytic mechanism than complement mediated cytotoxicity (7).
Dawson et al.(2) documented no significant diffe

References

1.
Badoual C, Hans S, Rodriguez J, Peyrard S, Klein C, Agueznay Nel H et al. Tumour-infiltrating CD4+ T-cell subpopulations in head and neck cancers. Clin Cancer Res. 2006;12 (2):465-72.
2.
Dawson DE, Everts EC, Vetto RM, Burger DR. Assessment of immunocompetent cells in patients with head and neck squamous cell carcinoma. Ann Otol Rhinol Laryngol. 1985;94 (4 Pt 1):342-5.
3.
Wolf GT, Lovett EJ 3rd, Peterson KA, Beauchamp ML, Baker SR. Lymphokine production and lymphocyte subpopulations in patients with head and neck squamous carcinoma. Arch Otolaryngol. 1984;110 (11):731-5.
4.
Wolf GT, Carey TE. Tumour antigen phenotype, biologic staging, and prognosis in head and neck squamous carcinoma. J Natl Cancer Inst Monogr. 1992;(13):67-74.
5.
Wanebo HJ, Blackinton D, Kouttab N, Mehta S. Contribution of serum inhibitory factors and immune cellular defects to the depressed cell-mediated immunity in patients with head and neck cancer. Am J Surg. 1993;166(4):389-94.
6.
Abbas AK, Lichtman AH (eds). Immunity to Tumours: Immune Responses to Tumours. Cellular and Molecular Immunology. 5th ed. ELSEVIER Inc., Philadelphia; 2005: 400-402.
7.
Greenberg PD. Mechanisms of Tumour Immunology. In: Parslow TG, Stites DP, Terr Al, Imboden JB,eds. Medical Immunology. 10th Lange/ McGraw-Hill Companies; 2001: 568-577.
8.
Cardi G, Mastrangelo MJ, Berd D. Depletion of T-cells with the CD4+CD45R+ phenotype in lymphocytes that infiltrate subcutaneous metastases of human melanoma. Cancer Res. 1989; 49(23):6562-5.
9.
Gonzalez FM, Vargas JA, Gea-Banacloche JC, Garcia JR, Berrocal E, Gorriz C et al. Functional and phenotypic analysis of T-lymphocytes in laryngeal carcinoma. Acta Otolaryngol.1994;114(6):663-8.
10.
Mandell-Brown M, Johnson JT, Rabin BS, Hamill E, Wagner RL. Neck node immunoreactivity in head and neck carcinoma. Otolaryngol Head Neck Surg. 1986; 95(4):500-6.
11.
Kuss I, Hathaway B, Ferris RL, Gooding W, Whiteside TL Imbalance in absolute counts of T lymphocyte subsets in patients with head and neck cancer and its relation to disease. Adv Otorhinolaryngol. 2005;62:161-72.
12.
Tables and Figures
[Table / Fig - 1] [Table / Fig - 2]

JCDR is now Monthly and more widely Indexed .