[in Japanese]

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The results of treatments of 341 patients with lung cancer in our department during the last 15 years and 8 months from January 1960 to August 1975 were reported. Of these cases, 18 were treated with operation alone, 22 with combined therapy of surgery and irradiation, and 301 with irradiation therapy alone. Of the 301 cases, 226 received more than 4000 rad (radical radiation therapy) and 75 received less than 4000 rad (palliative radiation therapy).
The five year survival rate and the median survival time were 58% and 39 months for the patients treated with operation, 15% and 21 months with the combined therapy of surgery and irradiation, and 6% and 10 months for the patients received the radical irradiation therapy. The two year survival rate and the median survival time of the patients with the palliative radiation therapy were 1.4% and 2 months, while the survival rate after 3 year in this group was 0%. In the patients who received the radical irradiation therapy, the better results were obtained in the patients with stage 1, having primary lesion in the left upper lobe and treated by the split course irradiation therapy. However, there were no marked differences in the treatment results according to sex, age and the types of primary lesion.
The prognosis of patients with undifferentiated small cell carcinoma was poorest showing only 6 months-survival rate of 60%, compared to patients with other histological types.

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The effects of various treatments of malignant pleural effusion were evaluated in 60 primary lung cancer patients and 22 non-lung cancer patients.By the thoracentesis or tube thoracostomy with local instillation of anticancer agents, pleural effusion was effectively controlled in 12 out of 39 cases (30%).By the instillation of radioactive isotope ¹⁹⁸ Au, it was controlled in 14 out of 30 cases (47%).By the ⁶⁰Co irradiation to tumor area or mediastinal lesion, it was controlled in 8 out of 13 cases (62%).By the instillation of BB solution (extracts of eight kinds of bacterias) or talk poudrage, it was controlled in 10 out of 13 cases (77%).
The median survival from the time of starting the treatment of malignant pleural effusion was measured in 34 cases out of 60 primary lung cancer patients.
The median survival was 5.5 months in 12 cases with not-decreased pleural effusion, and 10 months in 22 cases with decreased or disappeared pleural effusion.
By the stage classification of Japan Lung Cancer Society, 34 primary lung cancer patients were divided.In 20 stage HI patients, the median survival was 6 months in 4 cases with not-decreased pleural effusion, and 11.6 months in 16 cases with decreased or disappeared pleural effusion.On the other hand, in 14 stage N patients, the median survival was 4.8 motnhs in 8 cases with not-decreased pleural effusion, and 5.5 months in 6 cases with decreased or disappeared pleural effusion.
In stage DI, it is expected that control of malignant pleural effusion can prolong the survival.

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The relationship between tumor size, tumor doubling time (tD) and PPD skin test reactivity (PPD) was studied in 132 patients with resectable lung cancer which included various histological type of bronchogenic carcinoma. Serial x-ray films showed following tD; adenocarcinoma had an average doubling time of 116 days, squamous cell carcinoma of 94 days and large and small cell carcinoma of 71 days. TD was getting shorter with increased pathological stage.
There was no relationship between tumor size and tD in any type of carcinoma, however, it was strongly suggested that there was a certain relationship between these parameters if studies were carried out in those patients who had strong or weak PPD and who had a small size tumor less than 30mm on chest x-ray film.
These observations indicate that immunotherapy is important as an adjuvant after resection of the lesions in lung cancer patients.

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Forty one cases with lung cancer were found among the 97, 980 candidates for the various health screening organisations by our new system. This system consisted of two steps. At first, subjects at high risk of lung cancer were checkd up by symptoms and chest X-ray finding, and then sputum cytologic test were applied to this high risk group.
Among these cases with lung cancer, 9 (22%) were the early cancer, whose seven cases were diagnosed by the sputum cytologic test alone. Six in the nine were the “Chest X-ray negative” hilar early cancers.
The sputum cytology test needs minimum of 3 consecutive day specimens. Thus it was concluded that the means of our new system for lung cancer mass survey would be very effective, especially from the economical standpoint.

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In an attempt to clarify differences between local and systemic immune response, regional lymphnode cells (RLNs) and peipheral blood lymphocytes (PBLs) obtained from 19 patients with lung cancer were tested for PHA stimulation, T cell population, T cell subpopulation bearing IgG-Fc receptor.
PHA response rate of non-metastatic RLNCs was approximately two times higher than that seen with PBLs in stage I patients without any pre-operative therapy. With more advanced disease it becAme low, and it was less than half of that with PBLs when the nodes had been invaded with the tumor cells.
In relevant to the location of lymph node the closer to the tumor, the higher the PHA response, and vice versa.
T cell population was found to be lower in RLNCs than in PBLs. It tended to be higher in nodes closer to the tumor.
T cell subpopulation bearing IgG-Fc receptor was higher both in RLNCs and in PBLs than in control samples. No significant difference was observed between each of lymphnodes.

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A case-control study of 378 lung cancer patients and 756 control patients was conducted to investigate the association between cigarette smoking and lung cancer. Patients were interviewed at the hospitals of National Cancer Center (Tokyo), Tokyo Medical College, and Chiba University and the Research Institute for Tuberculosis, Leprosy and Cancer, Tohoku University (Sendai). The coding of questionnaires was conducted at the Department of Public Health, Tohoku University, and the data were processed at the Biometry Branch, U.S. National Cancer Institute.
The adjusted relative risk of smokers compared with that of non-smokers, computed by the Mantel-Haenszel method, was increased for male cigarette and kizami smokers, who smoked 20 or more cigarettes per day, who inhaled deeply, and who started smoking earlier in life. The relative risk for filtered cigarette users was lower than that for non-filtered cigarette users. Cigarette smoking is most closely associated with the epidermoid type of lung cancer.

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Eighty four cases of lung cancers treated surgically were studied histologically with special reference to the blood vessel invasion and prognosis after surgery.
The incidnce of blood vessel invasion for the entire cases was 63 percent, while it was 83 percent for epidermoid carcinomas and 47 percent for adenocarcinomas. According to the classification of Japan Lung Cancer Society'(New Classification) blood vessel invasion was found 36 percent for well differentiated cases in frequency, 64 percent for moderately differentiated cases, and 88 percent for poorly differentiated cases respectively.
Correlation with blood vessel invasion and prognosis after surgery was studied for 41 cases, whose post-operative course was followed exactly. The cases without blood vessel invasion survived 83 percent more than 3 years, while the cases with it survived only 21 percent more than 3 years and about 70 percent of those patients died within 2 years.
Connective tissue of the lung cancers was divided into three types, type I;abundant in fibroblasts, type Thiess fibroblasts and large numbers of collagen fibers, type IIl;almost collagen fibers and it may be show tendency of hyalin degenenation. The patients who had lung cancers with type II, or III showed poor prognosis after surgery.

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A 32 year old female noted blood-streaked sputum in May 1970 and consulted a physician, who discovered a coin lesion with diameter of 3 cm on the chest X-ray film in the left lower part of the lung. And she had received drug medication against lung tuberculosis under a diagnosis of the lung tuberculosis. But the lesion had grown rapidly, then to our hospital she was admitted on September 22th 1970 for a complete medical examination. A chest film disclosed a mass of 6.5×3.8 cm in the left lower field of the lung. Sputum cytology revealed class V; undifferenciated carcinoma. On Oct. 5th 1970 left lower lobe and simple lymphnode extripation was perfomed. Histopathological findings revealed Oat cell carcinoma. Postsurgical radiation was perfomed to the hilar part of the lung by Co⁶⁰ 4800 rad. She was discharged on Nov. 27th 1970 and she is checked twice a year by chest X-ray and at the present time she is healthy.

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A case of small cell anaplastic carcinoma accompanied with Eaton-Lambert syndrome was reported. The patient was a 47 year-old man who also showed cerebellar symptoms.
The electromyagram showed the wanning phenomenon in low frequency repetitive stimulation and the waxing phenomenon in high frequency repetitive stimulation. Clacium and guanidine hydrochloride were effective for the improvement of muscle movement. Histological study of the intercostal muscle showed type I grouping. In the electron microscopic finding, numerous widened and irregularly ramified secondary synaptic clefts were observed
Reports on Eaton-Lambert syndrome in Japanese literature were also reviewed.

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