IMMUNOLOGICAL EVALUATION OF PATIENTS WITH INVASIVE-CARCINOMA OF THE GALLBLADDER

Forty-three patients with invasive adenocarcinoma of the gallbladder w ere postoperatively studied in order to determine their general immuno logical status as well as the local immunohistological reaction to the tumor. At the end of the follow-up, they formed two groups: 19 living patients (group GL) and 24 dead patients (group GD). As a control gro up (GC), 21 patients with cholecistectomy for cholelithiasis and witho ut carcinoma were simultaneously evaluated. In GL, most of the tumors were limited to the gallbladder wall, and in GD, most of the tumors we re already disseminated at the time of diagnosis. GD presented a lower percentage of peripheral blood B lymphocytes, as compared to GL and G C cases. Skin tests of delayed hypersensitivity were significantly mor e reactive in GL cases than in GD cases, and less reactive in GD than in GC cases. The immunohistological evaluation of the gallbladder yiel ded a lower B lymphocyte infiltration in GD tumors than in the control cases. GL cases showed a higher intratumoral lymphocytic and mononucl ear cell infiltration than GD cases. Although the clinical stage was h igher in GD than in GL cases, there were also significant differences in the local immune response and the general immunological status. Pat ients with invasive gallbladder adenocarcinoma showing longer postoper ative survival revealed normal or increased local and general immunolo gical reactions, whereas patients with disseminated tumors showed an i mportant humoral and cellular secondary immunodeficiency.