Although the vast majority of early stage central type lung cancer is diagnosed fiberoptic bronchoscopically, histologically or cytologically, there are some cases in which localization can be difficult such as in cases of very early stage lung cancer, occult lung cancer or carcinoma in situ. Furthermore, some early stage lung cancer cases are ineligible for surgical treatment because of poor cardiopulmonary function.
The author performed basic studies on an experimental lung cancer series induced in dogs to evaluate the applicability of hematoporphyrin derivative (HpD) administration and-photoradiation in order to. evaluate the system's applicability in human cases. HpD has specificity for malignant tissue and can be activated by certain wavelengths of light to fluoresce or to have cytocidal effects upon the tumor cells. 2.5-3.0 mg/kg body weight of HpD was injected intravenously 48 hours prior to photoradiation in 7 dogs in which central type lung cancer had been induced by submucosal weekly injections of 20-methylcholanthrene. The laser beam used for diagnosis and location was a violet krypton ion laser, While the laser used for therapy was the red argon dye laser which yields better penetration. The laser beam was transmitted via a quartz fiber inserted through the instrumentation channel of the fiberoptic bronchoscope.
In order to observe the fluorescence emitted by the HpD when stimulated with the violet light, an image intensifier was employed, and in 6 of the 7 dogs fluorescence was recognized. No fluorescence was observed either in the cancer lesions of dogs which did not receive HpD administration or in the normal mucosa of normal dogs that did receive HpD. In 3 of the dogs photoradiation therapy was performed using the argon dye laser (100mW×10 min-200mW×20 min). The tumor disappeared in all 3 cases, and in 2 of the dogs that were sacrificed no lesion could be recognized on serial sections. No effect was seen following laser photoradiation of lesions of animals receiving no HpD or in the normal mucosa of normal animals.
Thus HpD and laser photoradiation will be applicable in the detection of tumors and extent of invasion and in the treatment of early stage central type lung cancer and in these cases may obviate the necessity of thoracotomy.

View full abstract

In order to elucidate risk factors of lung cancer according to histologic type, a casecontrol study was conducted on 101 pairs of lung cancer cases and their matched controls selected from 481 subjects through interviews by the author at Aichi Cancer Center Hospital from 1975 to 1981. The relative risks of smoking for Keyberg Group I (squamous cell, large cell, and small cell carcinoma) and Kreyberg Group II (adenocarcinoma) were estimated to be 7.0 and 1.3. Other risk factors revealed from this study were less frequency of bowel movement, history of asthma, and drinking milk (low) for Kreyberg Group I and occupational exposure such as to iron and other metals, large ratio of weight to height, and eating fruits (low) for Kreyberg Group II. The relative risks for the high and low risk factors obtained from a single factor analysis were confirmed by a multiple logistic regression analysis.

View full abstract

The frequency of various phenotypes of HLA antigen and soluble HLA antigen activity in plasma in 38 patients with lung cancer was investigated in this study. 102 healthy adult Japanese volunteers were used as controls. From the results obtained here, our conclusions are follows:
1) It was demonstrated that the frequency of All antigen was increased significantly in lung cancer patients who had an adenocarcinoma proven histologically, suggesting an association between the two.
2) As far as soluble HLA antigen in plasma is concerned, A9 antigen activity was significantly decreased in patients with lung cancer, compared with controls. By way of contrast, All and B15 were demonstrated to show higher activity than in control.
3) The soluble HLA antigen activity in plasma of patients with lung cancer may be a useful parameter for monitoring clinical stage.

View full abstract

Tumor was resected in 77 of 119 “ Stage III lung cancer cases undergoing Surgery”, in our department from January, 1965 to January, 1982, and in 23 of these 77 cases, extended operation with combined resection of surrounding structures such as the chest wall (9 cases), diaphragm (6 cases), pericardium (6 cases), and left atrial wall (2 cases) was performed.
Of the 23 cases of extended operation, 4 survived more than 2 years after surgery and one case was alive more than 5 years. The actuarial five-year survival rate was 9.6 percent (15.3 percent in semi-curative surgical cases). No significant difference was observed compared with the survival of 54 stage III cases undergoing pulmonary resection without combined resection. However, in 8 cases with non-curative extended operation, the survival rate was significantly lower in comparison with that of 15 patients with semi-curative resection. The survival rate of cases undergoing right pneumonectomy was also significantly lower compared to those of patients with left pneumonectomy or lobectomy. Relatively longer survival was experienced in cases of epidermoid carcinoma with diaphragm resection, and adenocarcinoma with thoracic wall resection. However, one N₂ case of adenocarcinoma involving the pericardium survived more than 3 years after surgery.
These results encouraged us to perform aggressive surgery with combined resection in selected cases of advanced lung cancer.

View full abstract

Effects of asbestos on lung and pleural tumorigenesis on N-bis (2-hydraoxypropyl) nitrosamine (DHPN) were studied in male adult Wistar rats. A total of 30 mg asbestos, (Canadian chrysotile, 5μm in diameter) was administered by intratracheal instillation or left intrapleural injection. DHPN in drinking water was administered at concentrations of 100 ppm or 500 ppm and DHPN in distilled water was given by a single intraperitoneal injection at a dose of 3 g/kg body weight. Mesotheliomas developed in 1 of 11 (9%) rats receiving intratracheal instillation of asbestos and intraperitoneal injection of DHPN, in 3 of 12 (35%) rats receiving intrapleural injection of asbestos and intraperitoneal injection of DHPN for 52 weeks, and in 1 of 10 (10%) rats receiving intratracheal instillaltion of asbestos and oral administration of 500 ppm DHPN for 35 weeks. Furthermore, high incidence of pleural changes, such as hyaloid thickening, mesothelial cell hyperplasia, and adenomatous or fibramatous pleural proliferation was observed in rats receiving combined administration of asbestos and DHPN. These changes were also seen in the bilateral pleura of rats receiving intrapleural injection of asbestos. Asbestos did not effect the incidence of lung tumor caused and by DHPN however, adnocarcinoma and combined squamous cell and adenocarcinoma were induced by combined administration of asbestos and intraperitoneal injection of DHPN.

View full abstract

We experienced 4 cases of lung cancer whose chest roentgenogram was negative. In the same period, 251 cases of lung cancer were treated surgically in our Department of Thoracic Surgery and only 4 cases (1.6%) were chest X-P negative cancer.
The cases were male, heavy smokers, cancer age over 40 and were admitted to our hospital with hemoptysis. Sputum cytology in all patients showed class V squamous carcinoma cell and the tumors were found in the lobar bronchus (3 cases) and upper division bronchus (1 case) by flexible bronchoscopy.
These tumors included 2 cases of superficial infiltrating type, one case of nodular infiltrating type and one case of polypoid type, and all were early stage central type lung cancer.
The surgical procedures were bilobectomy in 2 cases, lobectomy in one case and lobectomy with sleeve resection in one case. Sleeve resection is a useful surgical procedure for such cases.

View full abstract

A 49-year-old female was admitted to our hospital with chief complaints of dry cough and exertional dyspnea. From the diffuse miliary chest X-ray shadow, we suspected interstitial pneumonia. We obtained a definitive diagnosis of pulmonary metastasis of papillary adenocarcinoma on the third transbronchial lung biopsy (TBLB) procedure. The primary lesion was suspected in the thyroid, however there were no abnormal findings except diffuse T1C1 uptake in the lung on the scintigram. Autopsy revealed the primary lesion to be poorly differentiated papillary adenocarcinoma of the thyroid. Widespread metastasis including in the lung were found. It is suggested that TBLB is useful for the differential diagnosis of patients with diffuse disseminated lung shadows. It is also recommended to repeat TBLB to obtain a definitive diagnosis.

View full abstract

We experienced two interesting cases of mucus-producing adenocarcinoma of the lung surviving over twenty years with tumor. The first case was operated uponradically 15 years after the first recognition of an abnormal shadow in chest X-ray films, and reoperated upon for intrapulmonary metastases 7 years and 7 months after the first surgery. The second case also underwent radical surgery 9 years after the detection of an abnormal lesion on chest films, but the tumor recurred 9 years after the first surgery.
The tumors of both cases were extremely slow growing, which histologically resembled bronchioloalveolar carcinoma of goblet cell type but ultrastructurally and histochemically they appeared to resemble adenocarcinoma of the bronchial gland type.

View full abstract

A case of minute lung cancer was reported. Thoracotomy was performed to resect a lesion revealed on X-ray, and a small induration was found incidentally at a distance of about two centimeters from it. Histologic examination revealed that the former was only scar tissue while the latter was well differentiated adenocarcinoma. This carcinoma satisfied the criteria of peripheral type early stage lung cancer.
We discussed about peripheral type early stage lung cancer, scar cancer of the lung and limited operation for lung cancer.

View full abstract