Matsuda M, Horai T
Gan To Kagaku Ryoho. 1982 Oct;9(10):1695-703.
Since the diagnosis of lung cancer is made cytologically in most instances, the study of cytologic materials of lung cancer may be useful to plan the treatment schedule, to judge the effect of treatment and to find the recurrence of the lesion in central type lung cancer. Shibata et al. observed the correlation of morphologic changes of irradiated cancer cells and radiation doses, and found the close relation between them. In order to detect disappearance of cancer cell in the cytologic specimens, more than over 1000 r. was necessary for small cell carcinoma, more than 2000 r. For large cell carcinoma, more than 3000 r. For squamous cell carcinoma and more than 5000 r for adenocarcinoma, respectively. It suggests that small cell carcinoma is more radiosensitive. To predict the degree of response to radiotherapy, it is most important to decide the cell typing of obtained cancer cells. We investigated whether certain cytologic characteristics of small cell carcinoma could be correlated with response to chemotherapy. The cancer cells in the good response group more frequently showed finely granular chromatin evenly distributed through the nuclei. The cancer cells in the no/response group predominantly showed deeply stained nuclei with coarsely granular chromatin distributed evenly or pale nuclei with unevenly distributed chromatin. These findings may be an indicator to predict the degree of response to chemotherapy. Cytologic grading of irradiatic changes reported by Shibata et al. may be useful for judging the effect of treatment of lung cancer. We introduce three cases of lung cancer in this paper and reported the correlation of morphologic changes of cancer cells and the effect of treatment of those cases.
由于大多数情况下肺癌是通过细胞学诊断的,因此对肺癌细胞学材料的研究可能有助于制定治疗方案、判断治疗效果以及发现中央型肺癌病变的复发情况。柴田等人观察了受照射癌细胞形态变化与辐射剂量的相关性,并发现了它们之间的密切关系。为了在细胞学标本中检测癌细胞的消失,小细胞癌需要超过1000伦琴,大细胞癌需要超过2000伦琴,鳞状细胞癌需要超过3000伦琴,腺癌需要超过5000伦琴。这表明小细胞癌对放疗更敏感。为了预测放疗反应程度,确定所获得癌细胞的细胞类型最为重要。我们研究了小细胞癌的某些细胞学特征是否与化疗反应相关。化疗反应良好组的癌细胞更频繁地显示细颗粒状染色质均匀分布于细胞核中。无反应/反应组的癌细胞主要表现为细胞核深染,粗颗粒状染色质均匀分布,或细胞核淡染,染色质分布不均。这些发现可能是预测化疗反应程度的一个指标。柴田等人报道的照射变化的细胞学分级可能有助于判断肺癌的治疗效果。本文介绍三例肺癌病例,并报告癌细胞形态变化与这些病例治疗效果的相关性。