Myocutaneous flaps in patients with head and neck cancer retain their immunological capacities in an activated functional state

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Abstract
Free/pedicled myocutaneous flaps used as functional replacement after radical dissection of advanced stage squamous cell carcinomas of the oral cavity/oropharynx were examined by immunohistochemistry (APAAP‐technique). Biopsies from eight patients were taken at the time of surgery and at 3 and 5 months post‐operatively. Fifteen monoclonal antibodies were used to detect surface antigens as markers of phenotypic changes of immune competent cells. In post‐operative biopsies all antigens investigated increased significantly. Significantly higher numbers of CD45RO+ (P < 0.01)and CD45RA+ (P < 0.001) leukocytes were detectable. The majority of these leukocytes were TcR α/β+/CD3+ T‐cells. which increased in the CD4 (P < 0.05) and the CD8 (P < 0.001) subset. In addition. B‐cells (P < 0.05). granulocytes (P < 0.05). NK. cells (CD16+ lymphocytic cells: P < 0.05) and mature macrophages (25F9+cells; P < 0.01) were increased. Intra‐ and subepidermally a significantly (P < 0.01) higher number of dendritic‐Langerhans cells (CD1a+) was detectable. In post‐operative biopsies, the activation‐associated antigens 1CAM‐1. VCAM and HLA‐DR were expressed on significantly more mononuclear‐/endothelial cells and on keratinocytes. Our findings indicate that the myocutaneous flaps still contained cells with immunological capacities.