泌尿器科領域におけるリンパ系撮影法の研究 第3編: リンパ系撮影法施行前後における血中腫瘍細胞の検討

Abstract

In fifteen in-patients with malignant tumor in the urogenital organs, lymphography was performed. An appearance of tumor cells in the blood before and after the procedure was discussed accompanied with findings of lymphangiogram and prognosis of diseases. The collection of tuomr cells in the blood was done by fibrinogen method. 1) Tumor cells in the blood were found after the lymphog r a phy in 3 of the 4 patients with malignant tuomr with metastasis. One of them showed presence of tumor cells in the blood even before the lymphography, and also developed a pulmonary metastasis one month after the procedure. In the other two, there was no reason making the reason of appearance of tumor cells in the blood being due to the procedure. 2) No tumor cells in the blood was found in both 2 patients with malignant tumor with possible metastasis and without metastasis until one week after the lymphography. 3) Lymphography was performed in 51 cases of malignant tumors in both out and in-patients from Mar. 1963 to Dec. 1964. It was not clearly noticed that the procedure accelerated new metastasis toward the central lymph nodes except for one patient who seemed to develop metastasis in other organs by the procedure. 4) Patients who noticed the extensive metastasis in regional lymph nodes on the lymphangiogram generally showed worse prognosis, but it was not clear whether or not there is a close relationship between the prognosis and finding of tumor cells in blood. 5) In patients with malignant tumor, the procedure of lymphography did n o make cytosepsis, but there would be much possibility to make new metastasis to other various organs according to the quantity of contrast media and especially the speed of injection. Therefore the lymphography should be done with as small amount of contrast media as possible. 6) The intravenous use of chemotherapeutic agents before and after the procedure of lymphangiography could help for prevention of new metastasis following the procedure.