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The majority of our laryngeal and pharyngeal cancer patients had increased serum immunoglobulin values, which normalised in nearly all of the patients examined six month after successful surgical treatment. The decreased values of the serum immunoglobulins were found in patients with advanced tumours as well as in those with T1 and T2 tumours. Some of these latter patients also had a deficient cellular immune response, and it is likely that a combined immune deficiency was the leading factor which caused the malignancy in those patients.

The immunity deficiency as colateral effect of intra arterial therapy with methotrexate in oropharynx carcinoma was measured by lymphocyte stimulation tests. Ten patients taken in two groups were treated with different doses of methotrexate and citrovorum factor. In determined stages of the cellular cycle an extensive reactive trauma to the lymphocytes was detected. This is not the case in the usual measurement of the number of lymphocytes, leucocytes and thrombocytes. This method seems to be appropriate in order to establish the doses, period of time and frequency for application of the intra arterial perfusion with methotrexate.

On an average 35%, of the carcinomas of the pharynx are localized in the hypopharynx. 44 carcinomas of the hypopharynx were analyzed which were observed 1970-1979 in the Institute of Pathology of the University of Hamburg. The age peak lays in the 7th decade of age. 84% of the patients were male. 68% of the cases were localized in the sinus piriformis, 21% in the posterior wall and 11% in the post-cricoid area. The stage T4 of the TNM classification existed in 87% of the cases, a formation of hematic pulmonary metastases in 40%. The highest frequency of metastases if found in the carcinomas of the sinus piriformis. According to the WHO classification 91% of the carcinomas were squamous cell carcinomas and 9% anaplastic carcinomas. 9% of the squamous cell carcinomas were high differentiated, 52% moderate and 30% poor differentiated. A very distinct stromal reaction was observed in the high differentiated carcinomas. The plasma cells showed a high content of IgA and IgG as revealed by the application of the indirect immunoperoxidase method. The content of Ig-containing plasma cells is distinctly reduced in poor differentiated carcinomas or after radiation therapy. A positive marking of carcinoembryonic antigen could be demonstrated in high and moderate differentiated carcinomas, especially in the keratinized areas. Prestages of the carcinomas are leukoplakias with dysplasia and papillomas, early stages the carcinoma in situ. Risk factors are tobacco abuse, alcoholism and the Plummer-Vinson's syndrome.