抄録
Lately the cytodiagnose of the stomach has been given a satisfactory result by the improvement of gastrofiberscope. Consequently fresh desquamative cellular materials, especially cancer cells which does not always satisfy the criteria of malignancy so far accepted can be quite easily and frequently scraped. Because of the difficulty on determining direct smear preparation from the stomach during operation as positive or negative we attempted to reappraise the criteria of malignancy from the viewpoint of the process of degenerative changes of cancer cells and moreover the factor in gastric juice constituents which influenced cancer cells exfoliated in the sto-. mach.
The phase contrast microscopy and the supravital staining technic of acridine orange and methylene blue were applied. Uninjured fresh living cancer cells of the stomach were unstained with methylene blue, whereas with acridine orange each entire cell, whose nucleolus and cytoplasm showed no metach romasia, was stained light green. The cells under different degrees of injury were stained diffusely and clearly with methylene blue and their uncleolus and cytoplasm showed a metachromasia with acrid ine orange. The phase contrast microscopy elucidated that the cellular portion stained densely with meth-ylene blue and also the metachromatic portion with acridine orange were of considerable high density. It was possible to identify these functional changes not with fixed staining procedures, Giemsa and Papanicolau, but with the supravital staining method. Morphological changes such as the findings of chromatin movement to the periphery of nucleolus and nuclear membrane, intranuclear vacuolization, thick ness and irregular margin of nuclear membrane and striking cytoplasmic deformity occurred even in benign cells in proportion to the cellular degener ation. These findings were not characteristic of malignant cells, but were rather responsible for the degeneration of dead cells.
For the purpose of evaluating the influence of gastric juice on exfoliated cancer cells of the sto mach, the solutions of various concentrations were prepared by diluting hydrochloric acid with physi-ologic saline solution and into each solution was added 10000 Fuld unit/ml pepsin. Following the suspension of cancer cells desquamated from the resected gastric specimen into above prepared each solution, the influence of pepsin and acidity were observed. On adding pepsin into 1/30, 1/50 and 1/100N hydrochloric acid solutions respectively, the swelling types of nuclei were far more numerous than those in each pepsin non-administered solution. On add ing pepsin into 1/10 and 1 N hydrochloric acid solutions, cancer cells occurred nuclear pycnosis si milar to those in each pepsin non-administered so-lution and there appeared no differences between both cases. Moreover, when suspending desquama tive cancer cells in patient's own gastric juice, their chromatic and morphological changes were observed at regular intervals. Such changes were influenced by acidity of gastric juice and seemed to be irres pective of the quantity of pepsin.
on the other hand, the propagation of bacillus was prominent in gastric juice of hypoacidity, whose action and osmotic pressure must be one of inevi table factors in the degeneration of cancer cells.
