Abstract
Local infiltrates of eosinophilic leucocytes and macrophages and the deposition of acid mucopolysaccharides (AMPS) in 72 operable primary lung cancers and 17 isolated pulmonary metastases of known origin were correlated to tumour stage (radically or non-radically operable) and clinical course, by following the patients for 2-3 1/2 years. Half of the primary lung cancers showed strong local eosinophilia which, in combination with either strong macrophage infiltration or absence of AMPS reaction, characterized a very good prognosis in radically operable patients. No eosinophils, together with a strong AMPS reaction, indicated a very poor prognosis, irrespective of tumour stage. 16/17 metastases (7 different histologies) had either no local eosinophilia (13), strong AMPS deposition (12) or both (9). This suggests that malignant clones with great metastatic potential in general are characterized by absence of local eosinophilia and/or a strong AMPS reaction. These observations taken together indicate that local eosinophilia expresses an immune reaction which is, houl metastatic clones. It if does, metastatic success may be due to an escape mechanism based on the elaboration of AMPS.
Highlights
Summary.-Local infiltrates of eosinophilic leucocytes and macrophages and the deposition of acid mucopolysaccharides (AMPS) in 72 operable primary lung cancers and 17 isolated pulmonary metastases of known origin were correlated to tumour stage and clinical course, by following the patients for 2-3- years
The series consisted of 72 consecutive, operable patients -with primary lung cancer. 15 patients with isolated, unilateral or bilateral pulmonary metastases of known origin an(l 5 patients with unusual malignant lung tumours of various origins (2 teratomas. one germinal cell tumour, one non-classifiable tumour and one sarcoma of the lung)
FIG. 1.-Correlation of reactive patterns with tumour stage and clinical course in cases with primary lung cancer. leo, me stands for reactive pair "eosinophils and metachromasia", Ilma, me for reactive pair "macrophages and metachromasia" and II'eo, ma for reactive pair "eosinophils and macrophages"; 0, "no or little", + + + "positive" reactivity
Summary
Typical patterns for primaryT lung cancers Awere A and C, wTith 26 and 21 tumours, respectively. Most of them belonged to reactive patterns C and D (10 and 7 tumours, respectively) and 2 Ihistologic types of metastases (hypernephroma and adrenal carcinoma) elearly favoured pattern C (4/5 and 2/2 cases, respectively) irrespective of preoperative treatment or duration of malignant disease. In the radically operable patients the tumours were rather smaller in Groups A and B TABLE II.-Distribution of r-eactive patterns and tumiour sizes in patients with primary luny cancers, grouped by oper-ative stage and clinical course
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