Abstract
Many kinds of guidelines and general rules for clinical studies on the treatment of cancer have been reported. The histopathological judgment of chemo-radiotherapeutic effects is based on the Oboshi-Shimosato grading, which is divided into 5 classes (Grade 0 to IV) according to the damage of cancer cells or nests.
Generally, the area of destroyed cancer tissue is measured as a reference point for biopsy. This method is still being used today and there are no rules for the scope of observation. Moreover, it is not easy to correctly judge whether a cell is alive or dead and there are different judgments by pathologists. In other words, the histopathological judgment is ideologic and true scientific evidence is lacking.
I have examined many problems involved in judging the post chemotherapeutic state of surgical material by microscopic obersvations.
At present, it is important for histopathological judgment to do the following:
(1) We must make glass slides of surgical materials and observe all of them (for using the BLSS method) if possible.
(2) For the judgment, photographs of the damage of the cells, nests and stroma are used.
(3) The superficial change of the epithelium is valid for judgment, similar to damage to the deeper cancer tissue.
To reach a solution, it is necessary to discuss the difference of invasive front in terms of prognosis and predictive factors.
