Stages of development of immunologic response in the regional lymph nodes in invasive cancer of the uterine cervix.

In a review of histologic sections of regional lymph nodes removed during surgery in the course of invasive cancer of the uterine cervix from 84 patients there have been distinguished four basic stages of immunologic response. Active immune response (I and II stage) was detected in all patients with non-metastatic cancer and minimal stromal invasion and 41% of patients with advanced invasion. The regional lymph nodes, in these cases, exhibited increased number of small primary or secondary lymph follicles, proliferative sinus histiocytosis and expanded thymus--dependent inner cortex. In 59% of the patients with invasive cancer but without metastases the regional lymph nodes showed weak reactive capacities (III stage). In cases with minimal metastases the immune response was dissociated (IV stage). One group of lymph nodes showed an unstimulated pattern and others a high stimulated pattern.