気管支末しょう発生せんがんの細胞形態について 組織分化度，臨床病期との関係:組織分化度, 臨床病期との関係 [in Japanese] A cytological study of pulmonary adenocarcinoma originate in the peripheral bronchus of the lung, with special reference to its correlation of histological differentiation and clinical stage [in Japanese]
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末梢気管支発生の腺癌は, 術後, 予想外に早期に血行転移で失う場合がある. そこで切除肺腫瘍から捺印塗抹標本と組織標本を作成し細胞形態と組織分化度, 臨床病期との関係を研究し, 治療成績の改善に資したいと考えた. 検索対象は, 53例で全例, 肺葉切除術がなされている. 組織分化度が高くなるに伴い臨床病期1期+II期の頻度が高くなり, 肺胞上皮型は高分化型とほぼ同率であった. 細胞多形性, 核クロマチン量と核縁の折れこみ所見は組織分化度, 臨床病期と相関しているが, 肺胞上皮型は全例, 特徴所見に乏しかった.<BR>PAS染色では手技, 観察に特に注意をはらい陽性率と3型 (びまん型, 顆粒型, 塊状型) の陽性パターンに分類し, 客観性をもたせた. 細胞100個の観察から陽性率は低分化型で最も低く, 他型はほぼ同率であった. 臨床病期間の差異はみられなかった. びまん性は低分化型に低く肺胞上皮型に高かった. 顆粒型は低分化型に低く, 塊状型は肺胞上皮型に特異的に高率であった. しかし, 臨床病期別での差異はみられなかった. Alcian-Blue染色は, 陽性率, 矢谷氏分類IX型 (細胞表面型) 出現率とも肺胞上皮型に特異的に高くみられ, 臨床病期別ではIII期+IV期にやや低率であった.
There have been some instances of dying from adenocarcinoma which arise in the peripheral bronchus of the lung and tend to spread by way of vascular system early in the postoperative course of the disease unexpectedly.<BR>Accordingly the cytomorphology of those adenocarcinoma cells in correlation with their histological differentiation and clinical stage were reviewed in order to determine whether it may offer valuable information for improving the result in the treatment of those neoplasms.<BR>Material and Methods: The specimen examined in this study consisted of imprint touch smear and histological sections from a total of 53 cases in which surgical resections had been performed.<BR>All of the cytological slides were stained with Papanicolaou, PAS and alcian-blue stain respectively.<BR>As far as the histological differentiation is concerned, all of the cases were classified as well differentiated type in 29, moderately differentiated type in 9 and poorly differentiated in 6, including 9 cases composed of tall columnar epithelial cells as alveolar cell type, separately.<BR>With assignment of the clinical stage, they included 24 cases in stage I, 7 cases in stage II, 17 cases in stage III and 5 cases in stage IV.<BR>Results: Based on the observation made in this study, there was a striking correlation between the histological differentiation and clinical stage.<BR>The degree of the histological differentiation increased with the number of cases belonged to stage I and II.<BR>Subsequently, the incidence of the alveolar cell type was approximately, in accordance with that of well differentiated type.<BR>The pleomorphism, hyperchromasia, folding effects of nuclei among cytologic findings observed in the slides stained with Papanicolaou's method related to both of the histological differentiation and the clinical stage.<BR>There was, however, scanty of impressive cytologic findings considered useful for comparison with the histological differentiation and the clinical stage in all cases of alveolar cell type.<BR>In view of objective cells stained with PAS were classified them into diffuse, granular and block type, if they were positive.<BR>A total of 100 adenocarcinoma cells were observed in each of them and the poorly differentiated type yielded the lowest positive rate, compared with other types among which the positive rate did not significantly differ.<BR>No difference was, however, noted in between the positive rate of cells stained with PAS and the clinical stage.<BR>By the classification mentioned above, the diffuse type found to be rare in the poorly differentiated types was noted in a large percentage of cases belowing to alveolar cell type.<BR>Furthermore, granular type was found to be inconscpicuous in poorly differentiated types, whereas the block type was present remarkably at a high rate in the alveolar cell types.<BR>Those three types had no relationship to the clinical stage.<BR>The incidence of the cells which had positive with alcian-blue stain and belonged to IX type (cell surface type) by Yatani's classification was significantly high in the alveolar cell type.<BR>From the view of the clinical staging, the positive rate was relatively low in the cases of clinical stage III and IV.
- The Journal of the Japanese Society of Clinical Cytology
The Journal of the Japanese Society of Clinical Cytology 21(4), 693-701, 1982
The Japanese Society of Clinical Cytology