抄録
The purpose of this subject is the correlation between the clinical effect and the cancer cell damage of the anticancer drugs injected into the pleural and peritoneal cavity of the patients.
Anticancer drugs, such as MMC and Endoxan, were directly injected into the pleural and perito neal cavity of 17 patients with cancerous pleuritis or peritonitis more than three times.
The cells in pleuroperitoneal fluid were compared to the clinical effect. The injections of the anticancer drugs were clinically effective in five cases. The number of cancer cells per volume unit decreased remarkably in four of them, though the other case didn't reveal a noticeable change of cell count. However, in five of 12 cases clinically ine ffective, the number of cancer cells per volume unit decreased as in the effective cases. But no remarkable decrease of cell count was observed in the other 7 cases.
In most cases of the group whose cancer cell count decreased, the cell number began to drop after giving small doses of anticancer drugs.
The morphological changes of the cancer cells, by anticancer drug infusion, are mostly changes of nuclear chromatin pattern, especially nuclear pycnosis and vacuolation of the cytoplasma.In four of the five cases of the clinically effective group, more than half of cancer cells revealed morpholo gical damages by anticancer drug. In 12 cases of the clinically ineffective group, there were five cases with noticeable morphological cell changes (more than half of the cancer cells), five cases with poor cell changes (less than 20% of the cancer cells) and two cases that showed moderate cell changes.
On the relationship between the clinical findings and the increase and decrease of lymphocytes by anticancer drugs infusion, three of the five cases of the clinically effective group revealed increases of lymphocytes though the other two didn't show prominent changes of lymphocytes. In 12 of the clinically noneffective cases, there were no noticeable changes of lymphocytes except for one case.
Moreover, five clinically effective cases showed decreases of the number of cancer cells per volume unit, and an increase of morphologically changed cancer cells and an increase of lymphocytes was observed in three of them.
In more than half of 12 cases, no notable changes were observed in number of cancer cells, and the ratio of the morphologically stable cancer cells to damaged ones was not influenced. However, some cases showed similar findings to the cells of the effective cases, in the decrease of the number of cancer cells, and the increase of the damaged cancer cells and lymphocytes. In these cases, we would have expected greater improvement of the clinical condition of the patients, if their condition had permitted us to administer a larger dose of the anticancer drugs.
