CHANGES IN THE TISSUE SURROUNDING A GROWING TUMOR AND THE SIGNIFICANCE OF THE "PRECANCEROUS STATE.".

An analysis of the results of the experiments reported in this investigation shows that the changes so frequently observed in tissues surrounding a growing tumor may be caused by different conditions. The development and growth of a malignant tumor depends upon a local interaction between tumor cells and organ cells. When the cells of a normal organ are capable of inhibiting tumor growth, then an impairment of the normal state of the parenchymatous cells of this particular organ is essential for the growth of the tumor. This "precancerous state" does not consist primarily of an inflammatory change in the adjacent connective tissue, as Ribbert and his followers maintain, but in a degeneration of the parenchymatous cells of the organ. If, in another instance, the cells of the normal organs are unable to inhibit the proliferation of the tumor cells, then no preparation of the cells of the organ for the tumor is necessary, i. e., no "precancerous state" is needed to enable the tumor to grow. On the other hand, the proliferating tumor cells injure normal cells, either mechanically or chemically, producing a condition that appears on superficial examination like that described as the "precancerous state." In reality, however, this condition is the resultant effect of the tumor growth and may be more correctly designated the "postcancerous state." In these conditions, then, von Hansemann's explanation of the phenomenon, and not Ribbert's, seems to be the correct one. Of still greater importance is the fact demonstrated in the last series of experiments; namely, that the general condition of resistance or immunity to cancer growth exerts a greater influence on the organism of the animal than any of the local conditions described above. The local resistance of a testicle to tumor growth in a generally susceptible animal may be overcome, but if an animal is made generally immune to the growth of cancer, neither the animal as a whole nor a single organ or tissue in it can be made susceptible to the growth of the tumor.