A Histological and Cytological Study of Preoperative Chemotherapy for Gastric Cancer -Evaluation of the Nuclear Area of Cancer Cells Before and After Chemotherapy-

Shinji Yanagisawa

First Department of Surgery, Chiba University

To evaluate the effects of preoperative chemotherapy for gastric cancer, we examined the histological effects and the changes in the nuclear area of cancer cells calculated with a morphometer. Twenty-nine patients with resectable gastric cancer were treated with continuous intravenous 5FU injection (300 mg/m²/day) until the day before the operation. According to the Japanese classification of gastric carcinoma, histological changes showed Grade 0 in 8 cases, 1a in 13 cases, 1b in 5 cases, and 2 in 3 cases. The mean nuclear areas (NA) were 46.2±6.86 µm² before chemotherapy and 57.7±10.80 µm² after chemotherapy. The NA was significantly enlarged after chemotherapy. The changes in the nuclear area ratio (NAR= NA after chemotherapy/NA before chemotherapy) were related to the histological effects, but the NAR had a wide distribution in cases of Grade 1a. Therefore the histological changes were devided into 2 groups. Group A was the non-effective group (15 cases). This group included the cases of Grade 0 and showed a minor response in Grade 1a. Group B was the effective group (14 cases). This group included the cases exhibiting a marked response in Grades 1a, 1b and 2. According to this classification, the NAR was 1.12±0.170 in Group A and 1.42±0.235 in Group B. The NAR was more significantly related to the histological changes. Though histological effects were slight like the cases of Grade 1a, the nuclei of cancer cells were swollen after chemotherapy. It was suggested that the increase in NA was a good parameter for cytological effects of chemotherapy.

Key words
gastric cancer, preoperative chemotherapy, histological changes, swelling of cancer cells nuclei

Reprint requests
Shinji Yanagisawa Department of Surgery, Kimitsu Central Hospital
1010 Sakurai, Kisarazu, 292 JAPAN

Accepted
October 1, 1997

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