Stromal reactions to squamous cell carcinoma of the cervix

The characteristics of the stromal reaction to invasion by cancer were studied in 23 cases of cervical squamous cell carcinoma (stage Ib to IIb) and 86 control cases of benign disease of the uterus. Tissues taken from sites adjacent to tumor or from comparable sites in the nonmalignant uteri were analyzed for number of round cells, density of collagen and reticular fibers, and collagenase activity. The results were correlated with the depth of invasion and the histologic appearances of the tissues adjoining the cancer. Plasma cells and reticular fibers were most numerous in patients with slight invasion and no direct contact between the malignant and benign tissues (C type in CPL classification of Imai). Glycosaminoglycans (mainly hyaluronic acid and chondroitin sulfate) were present in the greatest amounts in C type stroma. The prognosis showed no correlation with either collagen content or collagenase activity but it was a better prognosis correlated with the collagen/collagenase ratio. It is concluded that increased numbers of plasma cells and reticular fibers and a high collagen/collagenase ratio are among the mechanisms protective against the invasiveness of cervical carcinoma.