Histologic material from 156 patients treated with surgery for cancer of the large bowel was studied with regard to tumor host interaction and with particular emphasis on the reactions of the regional lymph nodes. Prognostic evaluation of the tumor included the extent of the primary lesion according to Dukes' classification and the grade of differentiation of the carcinoma. Morphologic evidence of host resistance was judged by the presence and degree of lymphoplasmacytic infiltration of the tumor and the reactions of the regional lymph nodes, which were classified in four histologic patterns: lymphocyte predominance, germinal center predominance, lymphocyte depletion, and unstimulated. Of the factors evaluated, those that appeared to correlate best with five-year survival were the stage of the disease, the grade of differentiation of the carcinoma, the degree of lymphoplasmacytic infiltration of the tumor, the lymphocyte predominance pattern, and, to a lesser degree, the germinal center predominance pattern. None of the other morphologic features related to lymph nodes showed favorable prognostic significance. The relationship of morphology to host immune mechanisms is discussed.
We have studied the distribution of lysozyme (Ly), a1-antitrypsin (a1AT) and a1-antichymotrypsin ( a1AChy ) in the normal, chronically inflamed and neoplastic gall bladder mucosa using the peroxidase-anti-peroxidase (PAP) method. Ly was absent from the normal mucosa but it was found only in areas of glandular metaplasia of true antral type and in crypts of possible early metaplastic nature in cases of chronic cholecystitis. a1AT and a1AChy were also found in such metaplastic areas, but their presence was also observed immunohistochemically in areas of essentially normal and in non-metaplastic, chronically inflamed gall bladder mucosa. The possible local production of these substances by gall bladder epithelial cells is discussed. Ly, a1AT and a1AChy were also found in various histological types of adenocarcinoma of the gall bladder in varying degrees of frequency and intensity, unrelated to the histological type and invasiveness of the tumour.
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