家兎下顎骨内における VX_2 癌の増殖に関する実験的研究

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  • An Experiment Study on Growth of VX_2 Carcinoma in the Mandibular Bones of Domestic Rabbits

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Carcinoma of the mandible is divided clinically into two types : the peripheral type in which a carcinoma of the gingiva invades and grows, and the central type in which a carcinoma developing in the mandible invades and grows. Of these two, treatment of the carcinoma developing in the mandibular bone or the central type involves radical surgical resection including the surrounding normal mandibular bone and a combined use of preoperative and postoperative radiation therapy and chemotherapy. Radical resection including the central carcinoma however causes extensive morphological and functional impediments after operation in facial aesthetics, mastication, speech, and deglutition. It is therefore desirable to make the surgical margin radical but minimal in order to alleviate postoperative morphological and functional impediments. From this standpoint, in planning the surgical safety margin, it is extremely important to have sufficient knowledge of invasion and growth mechanisms of mandibular carcinoma. For the purpose of determining growth and invasion state of the central carcinoma developing in the mandibular bones, VX_2 carcinoma was transplanted into the mandibular bones of domestic rabbits and its invasion and growth state was investigated roentgenologically and histopathologically. The results were as follwos : 1. Roentgenological inspection of the state of invasion by growth of VX_2 carcinoma in the bone marrow showed mainly the moth-eaten type probably because the present experiment was a transplantation experiment into the mandible. Although bone destruction was slight and enlargement of the mandibular canal was not found roentgenologically, invasion by and growth of VX_2 carcinoma were extensive histopathologically. 2. The VX_2 carcinoma transplanted into the mandibular bones of domestic rabbits first developed resembling small cellulae in the bone marrow in the transplanted area, resorbed and destroyed trabecular cancellous bone, and then extended with time to the anterior and posterior sides, invading and growing. 3. The VX_2 carcinoma which was invading and growing in the bone marrow gradually invaded into enlarged Harversian and Volkmann's canals and provided the route of invasion by the VX_2 carcinoma into compact bone. 4. The VX_2 carcinoma which grew in the bone marrow destoryed the surrounding alveolar bone and invaded into the gingiva and grew. At the same time, it invaded into the periodontal membrane space, grew in periodontal membrane and grew exophytically from the gingiva. 5. The VX_2 carcinoma which grew in the bone marrow destroyed the mandibular canal and invaded epineurium, perineurium and endoneurium, and gradually invaded along the fascile into posterior side. 6. The foregoing experimental results indicated that the invasion by and growth of VX_2 carcinoma was far more extended histopathologically than indicated by slightness of bone destruction roentgenologically. Its invasion and growth in nerve also was thought to promote its extension further toward the anterior and posterior sides. These findings therefore provide important suggestions for planning the surgical safety margin for the central carcinoma of the mandible and for carcinoma of the gingiva which grew into the mandible.

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