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

1.对初次开腹行剖腹探查、细胞减灭术的晚期卵巢癌患者，术后行化疗，并行二次剖腹手术。这些病例被纳入这项回顾研究，以评价错位的组织病理学治疗效果。在浆液性囊腺癌病例中绘制原发灶的组织学图谱，并与二次剖腹手术的组织学结果进行比较。然而，化疗后肿瘤的组织学改变很难评价，因为肿瘤内有巨大的肿块形成、变性、坏死。因此，初步的组织学结果与临床化疗效果之间的相关性进行了研究。综上所述，组织学分级、核分裂像计数和淋巴浸润率等因素对预后和预测化疗效果有重要意义。结论：1.肿瘤标志物CA125、TPA、IAP的监测对预测化疗的组织学疗效有重要意义。对人肌肉样囊腺癌裸鼠连续移植瘤进行了实验性化疗。研究表明，在大多数病例中，组织学效果与CEA值有很好的相关性，但在一些病例中，CEA值与肿瘤大小无关。因此，人们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估标准。此外，对同一患者的原发和复发的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.