膀胱腫瘍に於ける染色体の研究

Abstract

Among various methods for diagnosing malignant tumo r s, the morphological method is, of course, the most important one at the present time. Now, there is no decisive method for diagnosis of malignancy of a given single cell. The malignacy of the tumor cell group is merely judged by its histological structures and the destructive activity to the surrounding tissues. When benignancy or malignancy is determined in vesical tumors, we make reference to the classification proposed by Broders (1922) and Jewett-Strong (1946), but this classification is not a precise index of malignancy. From cytological point of view, it is supposed that the tumor is proliferation of undifferentiated cells preceeded by a variation in normal soma cells by some cause. On the other hand, abnormal proliferation of these undifferentiated cells seems to have a close relation to intracellular hereditary elements. Accordingly, study of the chromosomes which are the carrier of hereditary elements has probably a significance for explanation of the genesis of melignant tumors, the selection of treatment, or the prognosis. From this point of view, chromosomes in tumor ce l l s are comparatively investigated in connection with clinical symptoms, pathohistological findings, etc. The chromosomes were stained with acetic dahlia after hy p otonic treatment. The nuclear type was analyzed by the V. J. R. classification. The results of observation of the chrom o some number are shown in Table 4. The distribution is very wide. Case 25 demonstrates very wide distribution such as 61-201. Case 32 contains at least two triploid stem cells with 63 and 68 chromosomes. The stem cells are not constantly present and are 45 in minimum and 87 in maximum. The hyperdiploidy chromosomes are most frequently observed. Table 16 shows the chromosome composition. Cases 3 and 12 show the composition similar to that of the normal soma cells, but the other cases reveal the characteristic chromosome compositions in each case. The marker-chromosome indic a ting the change of the chromosome structure is observed in seven cases (Table 16). The interrelationship betwe e n the histological findings and the number of chromosome is summarized in Table 16, although the observation performed is a small number. In papillary carcinoma (transitional cell cacer) of Type I in malignancy and Degree 0 in infiltration, the peaks are at a hypodiploidy, diploidy, and at a hyperdiploidy. In cases of Degree A in infiltration, the peak is at a hypodiploidy. In papillary carcinoma (transitional cell cancer) of Type II in, malignancy and Degree A in infiltration, the peak is in most cases at a hypodiploidy and at a hyperdiploidy. In case of Dagree B1 in infiltration, the peaks are at a hypertriploidy and at a hypertetraploidy. In cases of Degree By in infiltration, the peaks are at a hypotriploidy and at a hypertriploidy. In case of Degree C in infiltration, the peak is at a hypertriploidy. In non-papillary carcinoma (transitional cell cancer) of Type II in malignancy and Degree B1 in infiltration, the peak is at a triploidy. In case of Degree C in infiltration, the peak is at a hypotriploidy. In papillary c a rcinoma (transitional cell cancer) of Type III in malignancy and Degree A and B1 in infiltration, the peaks are at a hyperdiploidy. In case of Degree C in infiltration, the peak is at a hypotriploidy. In case of Degree D2 in infiltration, the peak is at a hypertriploidy. In non-papillary carcinoma (transitional cell cancer) of Type III in malignancy and Degree B1 in infiltration, the peak is at a hyperdiploidy. In case of Degree B2 in infiltration, the peaks are at a hypodiploidy and at a hypotriploidy. In case of Degree C in infiltration, the peaks are at a hypertriploidy, at a triploidy and at a hypertriploidy. In case of Degree D1 in infiltration, the peaks are at hypotriploidy and hypertriploidy. In case of Deg ree D2 in infiltration, the peak is at a hyperdiploidy. In non-papillary carcinoma ( a denocarinoma) of Type III in malignancy and Degree D1 in infiltration, the peak is at a hypertriploidy. In non-papillary carcinoma (s q uamous cell cancer) of Type III in malignancy and Degree D2 in infiltration, the peak at a hypertriploidy. In non-papillary carcinoma (s q umous cell cancer) of Type IV in malignancy and Degree C in infiltration, the peak at a hypotriploidy. In non-papillary carcinoma (undifferentiated cell cancer) of Type IV in malignancy and Degree C and D1 in infiltration, the peak is at a hyperdiploidy. In case of Degree D2 in infiltration, the peaks are at a hyperdiploidy and at a hypotriploidy. In non-papillary carcinoma (transitional cell cancer) of Type IV in malignancy and Degree D2 in infiltration, the peak is at a hypotriploidy. A simultaneous observation of the patho l ogical findings and the chromosome structure shows, regardless of Type of tumor development and Degree of infiltration, that the appearance of abnormal chromosomes plays a significant role for diagnosing the malignant tumor cells because of the composition characteristic of the malignant tumor. The number of the chromosome in the stern cells is diploidy in Type I, as shown Table 17, but then increases in number ; in detail, the number is most large in Type II and B, moderately large in Type III and A or B, and slightly in Type IV. The number of the chromosome in the stem cells does not increase with the development of malignancy but in reverse reduces at a maximum of malignancy. It is supposed from these facts that the variation in the chromorome number and the analysis of the chromosome type are the important factors for distinguishing malignant cells from normal cells.