Adriamycin膀胱注入療法の病理組織学的検討

Abstract

膀胱腫瘍手術前の短期間にADMを膀注し, その腫瘍細胞に与える影響を病理組織学的に検討した.26症例中3例に腫瘍の消失を認めた.腫瘍の主要な病理組織学的変化は, 細胞の萎縮, 剥離および壊死であり, これら変化はADMの化学毒性により誘発される可能性がある

Since the study of intravesical instillation of thio-TEPA by Jones and Swinney, the method of topical chemotherapy with several anti-cancer drugs for superficial bladder tumors have been reported and it is now an established method of anti-bladder cancer treatment. Adriamycin is one of the most common topical agents against bladder tumor today. We studied the histopathological changes associated with the topical treatment in 26 cases of bladder cancer, all in which either TUR-Bt or cystectomy (partial or radical) had been performed after intravesical instillation of adriamycin. Transurethral biopsies of bladder tumor were done before the chemotherapy, and these findings were histopathologically compared with those of the surgical specimens. In 3 of the 26 cases, the tumors disappeared completely. In the other 23 cases, the main changes were: 1) cellular atrophy of tumor, 2) exfoliation, 3) interstitial hyalinous degeneration, 4) hemorrhage, and 5) dystrophic calcification. These changes are nonspecific of adriamycin, which seems to act as a toxic substance despite its potential activity to inhibit RNA replication.