A Trial Establish the Criteria for Evaluation of Direct Chemotherapeutic Effect in Ovarian Cancer -Forcussing on Cases with Second Look Laparotomy-

1.晚期卵巢癌患者行首次剖腹探查和肿瘤细胞减灭术，术后接受化疗，并在我科进行二次剖腹探查。这些病例进入本回顾性研究，以评估不良的组织病理学治疗效果。在浆液性囊腺癌的病例中，制作切除的原发肿瘤的组织学图，并与第二次剖腹探查的组织学结果进行比较。然而，由于肿瘤巨大肿块的形成、变性、坏死，给化疗后的组织学评价带来很大困难。因此，初步的组织学结果和临床化疗效果之间的相关性进行了研究。结论：组织学分级、核分裂计数、淋巴管浸润是判断预后和化疗疗效的重要因素。结论：1.肿瘤标志物CA125、TPA、IAP的检测作为无可测量病灶患者化疗效果评价的一项试验，对预测化疗的组织学疗效有重要意义.对人粘液囊腺癌裸鼠移植瘤进行了实验性化疗。研究表明，在大多数情况下，组织学效果与CEA值有很好的相关性，但在其中一些情况下，它与肿瘤大小无关。因此，认为有必要重新考虑日本癌症治疗学会提出的直接化疗效果评价标准。此外，对同一患者的原发性和复发性肿瘤裸鼠移植瘤进行了实验性化疗。

1. The cases with advanced ovarian cancer who underwent exploratory laparotomy and cytoreductive surgery at initial laparotomy received chemotherapy postoperatively and also underwent second-look laparotomy in our department. These cases were entered into this retrospective study to evaluate mislleneous histopathological therapeutic effect. The histological map of the resected primary tumor was made in cases with serous cystadenocarcinoma and compared to the histological findings at second-look laparotomy. However, there was much difficulty to evaluate the histological change with chemotherapy, because of giant mass formation, degeneration, necrosis. Therefore, a correlation between the initial histological findings and clinical chemotherapeutic effect was investigated. Conclusively, the factors such as histological grading, mitotic count, and lymphatic infiltration were considered important in prognosis and in predicting chemotherapeutic effect. As a trial for evaluation of chemotherapeutic effect in cases without measurable lesion, monitering of tumor markers such as CA125, TPA, IAP was thought to be of great use in predicting histological effect of chemotherapy.2. The experimental chemotherapy against serially transplanted tumor of human muscinous cystadenocarcinoma in nude mice were done. The study showed that histological effect was well correlated to CEA value in most cases, though in some of them it was not correlated to tumor size. Thus, it was considered that reconsideration of the criteria for evaluation of direct chemotherapeutic effect postulated by JAPAN SOCIETY FOR CANCER THERAPY would be necessary. Furthermore, the experimental chemotherapy was done against the primary and the recurrent tumor xenograft in nude mice from the same patient.