Prognosis of the pancreatic cancer in terms of the regional lymph node reaction.

Abstract

In order to elucidate the immunological defense mechanism in tumor bearing hosts against pancreatic cancer, tissue reactions of the regional lymph nodes were investigated in terms of extension and prognosis of pancreatic cancer. As the site for investigation of lymph nodes, the paracortical area, germinal center and sinus histiocyte systems were selected. In each case paracortical hyperplasia, germinal center hyperplasia and sinus histiocytosis were graded and the relationship between grade and prognosis of resected pancreatic cancer was studied with the following results. The grades of each tissue reaction in cases without lymph node metastasis were higher than that observed in cases with metastasis. There was a significant difference in sinus histiocytosis (p less than 0.01). Higher grade tissue reactions were observed in cases with primary lesion histologic type classified as papillary adenocarcinoma or as well-differentiated tubular adenocarcinoma as compared to those in cases of poorly differentiated histologic type. In pancreatic cancer the prognosis was better in cases with higher grade of tissue reactions of the regional lymph nodes. In cases with pancreatic cancer both cellular immunity and humoral immunity are involved in the host defense mechanism. It was considered that sinus histiocytosis is significant as an indicator for good prognosis and a factor to inhibit progression in pancreatic cancer.