Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

子宮頸癌根治手術患者に於ける流血及び手術創洗滌液の細胞学的研究 特に血管侵襲並びにリンパ節転移との関連について

Nishihara, Teruo
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92 patients, operated on radical surgery of the cancer of the uterine cervix after the irradiation of telecobalt 2,000 R. at the Dept. of Obst. & Gynec. Okayama Univ. Med. School, were studied on atypical cells appeared in the peripheral blood (before and after radical operation), in the uterine venous blood and in the wound washings. The cell-collection technique utilizing gum arabic-glucose was followed by the principle of H. Munakata's method. Papanicolaou's staining were applied to all specimens examined. As the result, 13.0% of atypical cells resemble to cancer cells were found in the peripheral blood (before operation), 14.6% in the uterine venous blood, 8.7% in the peripheral blood (after operation) and 25.0% in the wound washings, respectively. The blood vessel invasion of cancer ccells was found to be 29.3% in primary focus. Although the close correlation between blood vessel invasion and lymph node metastasis was found, the correlation between blood vessel invasion and atypical cell appearance could not be observed. A clinical stage or a parametrial infiltration was not correlated with atypical cell appearance. It seemed to be a slight correlation between lymph node metastasis and atypical cells appeared in the circulating blood, however, it was statistically insignificant. A significant correlation between the grade of the lymph node infiltration and atypical cells appeared in the wound washings was found. Therfore, it is considerd that the possibility of the dissemination of cancer cells into the peritoneal cavity may occur duriug operative procedures, especially by lymph node resections. On the other hand, a vaginal wall infiltration, a parametrial infiltration or a blood vessel invasion were not correlated with atypical cells appeared in the wound washings. Atypical cells resemble to cancer cells were found in the peritoneal fluid even among benign gynecological diseases. A correlation between atypical cell appearance and the prognosis of the patient is now under investigation.