Yamada H
Dept. of Surgery, National Fukuoka Chuo Hospital.
Gan To Kagaku Ryoho. 1990 Mar;17(3 Pt 2):524-31.
For the purpose to establish the reliability of SRCA using clinical materials, a histological assessment under the suppression of host reaction was introduced; 1) for the immune suppression cyclosporin A (CsA) was used, 2) to overcome the heterogeneity of fragments, the numbers of implants were increased to ten per group (two pieces/kidney), 3) time flame was 6 days as original, 4) the amounts of drugs were essentially similar to those of Bogden's original method. Drugs solely enough to induce immunosuppression such as 5-FU, CPA and MTX were administered by themselves and those not enough such as MMC, ADM and CDDP were done with least enough usage of CsA, 5) histological changes were analysed from three factors such as grade of degeneration (5 grades), tumor cell amounts (3 grades) and numbers of mitosis (3 grades). The histological analysis form representing the numbers of implants of each group on the indicated places by the individual grades of those 3 factors was devised. With this form, chemosensitivity results were expressed as ++, +, +/- and -. In a panel of more than one +/- results a sensitivity ranking was put on. 5) Macroscopic assessment was made by the measurement of height of the implants at day 6 for simplicity only for future relevance. This method of histological SRCA was applied on one parotid, one pancreas and ten colon cancers where viable tumor cells with frequent mitosis were seen in the CsA treated control groups and, on the other hand, occasional apparent degenerations were observed in some of drug treated groups. These facts verified that this histological assessment was practical and rational and covers the disadvantage of macroscopic findings.
为了确定使用临床材料进行SRCA的可靠性,引入了在宿主反应抑制下的组织学评估;1)免疫抑制使用环孢素A(CsA);2)为克服碎片的异质性,每组植入物数量增加到10个(每肾2片);3)燃烧时间仍为6天;4)药物用量基本与Bogden的原始方法相同。单独使用足以诱导免疫抑制的药物如5 - FU、CPA和MTX,而对于不足以诱导免疫抑制的药物如MMC、ADM和CDDP,则使用最少剂量的CsA;5)从三个因素分析组织学变化,即变性程度(5级)、肿瘤细胞数量(3级)和有丝分裂数量(3级)。设计了一种组织学分析表格,按这三个因素的各个等级表示每组植入物在指定位置的数量。根据此表格,化疗敏感性结果表示为++、+、+/-和-。对于一个以上+/-结果的一组,给出敏感性排名。5)为了简单起见,仅为未来相关性,在第6天通过测量植入物高度进行宏观评估。这种组织学SRCA方法应用于1例腮腺癌、1例胰腺癌和10例结肠癌,在CsA处理的对照组中可见有频繁有丝分裂的存活肿瘤细胞,而在一些药物处理组中偶尔观察到明显变性。这些事实证明这种组织学评估是实用且合理的,弥补了宏观检查结果的不足。