Abstract
To investigate the role of AgNORs for evaluation of chemotherapy, change of AgNORs was observed before and after chemotherapy. A comparative review was also made by histological evalution of chemotherapy for stomach cancer. Twenty-three patients with stomach cancer were treated by chemotherapy ; 17 with 5'-DFUR, and 5 with CDDP. The mean number of AgNORs was 5.75±1.02 before treatement and 3.83±0.97 after treatment. There was a significant difference between groups (p<0.01) . In classification of the nucleus form: A type had a large solitary round argyrophil structure, with a significant increase of AgNORs (0.24±0.23 before and 1.21±0.59 after chemotherapy, p<0.01) . A significant decrease of AgNORs was found in both B type (several small dots as 1.51±0.80 before and 0.33±0.4 after chemotherapy) ; and D type small black dots (3.79±1.41 before and 2.25±0.94 after chemotherapy, p<0.01) . Depth invasion revealed significant decrease in AgNORs in both PS (-) and PS (+) groups. The number of AgNORs in the PS (-) group was 5.95±1.13 before and 3.43±0.97 on the mucosal surface, 3.83±0.38 at the tip part after chemotherapy. In the PS (+) group it was 5.63±0.91 before and 4.14±0.84 on the mucosal surface, 3.69±0.53 at the tip part after chemotherapy. In the decreasing rate, the PS (-) group was greatly reduced on the mucosal surface (p<0.05) . Both differentiated type and undifferentiated cancer types showed significant decrease of AgNORs (p<0.01), and the decreasing rate was only slightly affected by the differentiation. In the histological evaluation of chemotherapy for stomach cancer, grade 0, I a, I b, and II were adapted in 7, 8, 4, and 4 patients respectively. Even in patients with grade 0, the AgNORs number was 6.28±1.04 before and 3.32±0.90 on the mucosal surface, 3.66±0.50 at the tip after chemotherapy. Thus, a significant decrease was obtained (p<0.05) and the decreasing rate was significant on the mucosal surface. Even in patients with grade I a or more, the AgNORs was 5.54±0.96 before and 4.05±0.94 on the mucosal surface, 3.66±0.50 at the tip part after chemotherapy. Thus, a significant decrease was observed (p<0.01) and the decrease rate was high at the tip part. In the histological evaluation of chemotherapy, 7 patient of the 5'-DFUR group showed grade 0, and 10 patients showed grade I a or more. In the CDDP group, 6 patients in all showed grade I a or more. In the change of AgNORs, 5'-DFUR showed a higher decreasing rate on the mucosal surface after chemotherapy, whereas CDDP showed a higher decreasing rate at the tip part. Thus, the effect-appearing positions were different by the type of agent and method of administration. Accordingly, it was suggested that, the change of AgNORs in preoperative chemotherapy was reflected with morphological change by chemotherapy even in patient with no histological change. Thus, the present method might become an auxiliary means for judging the effect.
