(Slaney, 1971;Gill and Morris, 1978). In addition, patients with 'early' lesions, Dukes stage A or B, and those who can be offered an anterior instead of an abdominoperineal resection enjoy a survival advantage (Gill and Morris, 1978).Despite these clinical prognostic observations, the final denominator determining survival is the host tumour interaction. This response is best seen in the tumour invasion profile, which can be used to predict the likely disease progression (Montessori and Donald, 1978). This profile is possibly an expression of tumour factors like their ability to secrete mucus or their histological grade (Grinnell, 1939) and the host immunological reaction to the tumour. Previously we have examined the host immune response to carcinoma of the colon by measuring the lymphocyte invasion of the tumour specimen (Watt and House, 1978) and the leucocyte migration inhibition response of patient's leucocytes to their tumour (House et al., 1975). The present study extends these observations. Received for publication 26 April 1979
Methods
PATIENTSThe subject under study included 107 individuals with colorectal carcinoma on whom a series of 340 leucocyte migration inhibition observations were made. The tumors of these same patients were examined for invasion by lymphocytes. Review of these 107 patients showed there were 29 right, 45 left colonic, and 33 rectal tumours and, among these, 29 were stages Dukes A, 37 Dukes B, and 41 Dukes C. The observation time was from two to six years or until death. The details relating to patient follow-up were collected retrospectively from hospital records, general practitioners, and the Registry of Deaths in Western Australia. The patients' differential white blood cell counts were not regularly available to correlate with the in vitro assays.Three hundred and forty leucocyte migration inhibition assays were also performed on a control group of 150 patients who were attending the hospital for disease which was not neoplastic or immunological in nature. They were selected to match the patients for blood group, age, severity of operative trauma, and time after surgery at which the tests were performed. 868
Quantitative analysis of the lymphocyte infiltration at the periphery of colorectal carcinomata has revealed a statistically significant difference, p < 0.001, in the distribution associated with Dukes B compared with Dukes C tumors of moderate differentiation.
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