[Prognosis of the pancreatic carcinoma in terms of the regional lymph node reaction].

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