<原著>肺癌の手術予後に関する臨床的ならびに病理学的検討 : 〔後篇〕病理学的検討

Abstract

A study was made of the correlation between histopathology and postoperative prognosis in 319 resected cases of lung cancer, including 35 small cancers less than 3cm in diameter, and 111 autopsy cases. 1. The prognosis following the resection of lung cancers is very difficult to predict on the basis of histopathological findings. However, some factors are worth considering in relation to the postoperative course. a. Among the various types of lung cancers, adenocarcinomas have a comparatively favorable postoperative course. b. Cases with detectable blood vessel invasion, especially of veins and capillaries, have a poor prognosis. c. In cases of adenocarcinoma, the presence of even one histological criterion suggesting high grade malignancy points to a poor prognosis. 2. Lung cancers less than 3cm in diameter were examined histopathologically in detail, and the following conclusions were drawn : a. Histological pleomorphism is not common in small lung cancers. b. The postoperative prognosis of small lung cancers is poorer for adenocarcinomas and is not always unfavorable in anaplastic carcinomas. This discrepancy in prognosis between small and more advanced adenocarcinomas seems to depend partly on the fact that some adenocarcinomas metastasize to distant areas easily, and some do not. 3. Thus it must be emphasized that the histopathology of small lung cancers is significantly different from that of more advanced cancers, particularly in autoposy cases. 4. The growth rate of lung cancers as determined roentgenographically does not always correlate positively with the histological appearance of malignancy or the postoperative prognosis.