Prognostic significance of histologic host response in cancer of the large bowel.
ABSTRACT 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.
[show abstract] [hide abstract]
ABSTRACT: The concept that the immune system can recognize and destroy nascent transformed cells was originally embodied in the cancer immunosurveillance hypothesis of Burnet and Thomas. This hypothesis was abandoned shortly afterwards because of the absence of strong experimental evidence supporting the concept. New data, however, clearly show the existence of cancer immunosurveillance and also indicate that it may function as a component of a more general process of cancer immunoediting. This process is responsible for both eliminating tumors and sculpting the immunogenic phenotypes of tumors that eventually form in immunocompetent hosts. In this review, we will summarize the historical and experimental basis of cancer immunoediting and discuss its dual roles in promoting host protection against cancer and facilitating tumor escape from immune destruction.Nature Immunology 12/2002; 3(11):991-8. · 26.01 Impact Factor
[show abstract] [hide abstract]
ABSTRACT: In experiments with suspensions of cells from colonic carcinomas, we noted that some colonic carcinomas contain large numbers of eosinophils. We therefore carried out a prospective study with 67 almost consecutive colonic carcinomas in our medical center after optimal fixation and staining for the demonstration of eosinophils. Infiltration of the primary tumor by eosinophils was found to have marked prognostic significance. The proportion (4 of 17 or 23.5%) of carcinomas with more than 30 eosinophils/sq mm that had metastases was significantly less (p = 0.01) than the proportion (31 of 50 or 62.0%) of carcinomas with less than 30 eosinophils/sq mm that had metastases. At 18 months, following the resection of tumor in patients without metastases, all of the patients (9 of 9) with greater than 30 eosinophils/sq mm were alive in contrast to 73.7% (11 of 15) of the patients with less than 30 eosinophils/sq mm. The number of survivors at 18 months for the total population without regard to metastases was significantly greater (p = 0.028) for those with greater than 30 eosinophils/sq mm than for those with less than 30 eosinophils/sq mm. We conclude that the quantitative assessment of eosinophils is one of the most important aspects of the microscopic evaluation of this common human tumor.Cancer Research 07/1983; 43(6):2997-3000. · 7.86 Impact Factor
Article: Inflammatory Cell Reaction: Study Of One Of The Important Prognostic Factors In The Patients Diagnosed Of Colorectal Carcinoma[show abstract] [hide abstract]
ABSTRACT: Objectives: Present study has been designed to study the prognostic importance of inflammatory reaction in colorectal carcinoma. Methods: Resected specimens showing presence of colorectal carcinoma were included in the present study. For this study information about history and investigations done was obtained from the clinical charts. The inflammatory reaction was assessed on the basis of general impression of amount of inflammatory cells along the entire tumor edge away from areas of frank abscess formation and scored as 0=prominent inflammatory infiltrate(dense) and score1=inconspicuous inflammatory infiltrate (mild/absent) 1. No attempt was made to evaluate the proportion of the various inflammatory cells unless many eosinophils observed in which case the infiltrate were classified as eosinophilic. The presence of abscesses was also noted separately. The presence of perivascular collection of lymphocytes was noted, even if they were located at some distance from the tumor margin itself. Results and Discussion: In present study total 37 resected colorectal specimens were studied. None of the case with dense lymphoplasmacytic (mononuclear) stromal infiltration showed lymph node metastasis. 64.7% of the cases with mild or absent lymphoplasmacytic (mononuclear) stromal infiltration showed involvement of lymph nodes. Lack of inflammatory reaction has more prognostic significance than presence of moderate to intense inflammatory reaction 2. According to Murray D. and Dutton J. (1967) local inflammatory reaction found in 52.7% cases were associated with significantly higher survival rate. According to them lack of inflammation at the periphery of colonic carcinomas was associated with worst prognosis 3. Watt and House H.K. (1978) analyzed that the lymphocytic infiltration at the periphery of the colorectal carcinoma had significant difference in distribution associated with absence of lymph node metastasis and lymph node metastasis tumors of moderate differentiation 4. According to Nacopoulou L.(1981) cellular immune competence as evidenced by lymphoplasmacytic infiltration of tumor cells has been associated with increased patients survival in colon cancer .According to them the 5 year survival rate was higher in the presence of lymphoplasmacytic infiltration 5. Zarbo R.J. (1994) 6 and Compton C.C. (1997) 7 showed that lymphocytic response at the edge of the invasive tumor was a favorable prognostic factor. It has been reported by several investigations that patients whose carcinomas were associated with marked lymphocytic and plasmacytic stromal infiltrate had better prognosis and a lower incidence of lymph node metastasis than patients in whom such as an inflammatory cellular reaction was mild or absent. Eosinophilic infiltration may be associated with a favorable prognosis 2, 3. We were unable to find any independent prognostic influence of eosinophilic infiltrate.