5]

Survival time of resected lung cancer cases according to cytodlfferen- tlatlon ( 1 7 )

Daym 400 800

Ultrastructural Characterization and Prog- nostic Features of Tumor Cells in Adeno- carcinomas of the Bronchus. Sugiyama, S., Tatsumura, T., Tsuda, M., Murakami, A., Koyama, S., Konaka, C., Yamamoto, K. Department of Surg., School of Medicine, Toyama Medical & Pharmaceu- tical University, Toyama, Japan.

Biopsy specimens of 20 adenocarcinomas and 8 epidermoid carcinomas in alveolo~ bronchial tract were observed. Materials were fixed in 2.0% osmium tetroxide buf- fered with 2.0% phosphate buffer and ana- lyzed in a Hitachi H-300 electron micro- scope. The results obtained were as fol- lows: According to our ultrastructural aspects, adenocarcinomas of the lung are classified to (i) Clara cell type, (2) Type II alveolar cell carcinoma, (3) gob- let cell type, and (4) bronchial gland cell type. Especially, among the goblet cell type carcinoma, rough endoplasmic reticulum (rER) like structure were seen near basement membrane in the cyto~ plasm of tumor cells. This appearance are suggesting the high grade differentiation to the mature goblet cells. And, if the tumor has a type (3) pattern and rER like structures in almost areas, a relatively better prognosis is likely.

Histopathological Prognostic Predictors of the Stage la and Stage III Lung Cancer. Kurita, A., Shimizu, N., Ando, A., Naga~a- wa, H., Fara, F., Teramoto, S., Taguchi-, K. 2nd Dept. Surg., i. Dept. Pathol,, Okayama Univ. Med. School, Okayama, Japan.

For past several decades, there have been debated on the many histopathological prognostic predictors of the lung cancer. But there are very few papers that assess the factors as regards each post-surgi- cal stages.

We examined the resected specimens, re- sected at our institute from 1972 to 1980, total of 183 cases. From the formalin- fixed materials, three levels of the tumor mass with its adjacent areas were examined. The regional lymph nodes were also examined at the level of the great~ est plane. As regards the tumor itself, tumor size, histological subtype, diffe- rentiation of tumor cells, necrosis, mito-

tic index(MI), blood vessel invasion

(BVl), infiltrating pattern, fibrosis and inflamma- tory cell infiltration were examined. On the regio-

nal lymph nodes, paracortical hyperplasia(PH) and follicular hyperplasia were particularly examined. Each factors were assessed comparing the numbers of the 3-year survivors and non-survivors.

Stage Ia, Adenocarcinoma (Ad); 28 cases. Mitotic index <0.005 group shows better prognosis.

Stage la, Squamous carcinoma (Sq); 30 cases. Blood vessel invasion negative group shows signifi- cantly better prognosis. Tumor size < 5 cm, mitotic index <0.016, intense inflammaroty cell infiltrati- on indicate better prognosis.

Stage III, Ad; 32 cases. Necrosis negative group shows significantly better prognosis. High grade paracortical hyperplasia group also shows signi- ficantly better prognosis. Tumor size < 3 cm group indicates better prognosis.

Stage III, Sq; 13 cases. No predictors are de-- tected.

Prognostic Reliability of Some Morphological Para- meters in Post Surgical Stage I°Adenocarcinoma of the Lung. Barberis I, M., Casadio I, C., Borghini 2, U., Soresi 2,

E. i. Department of Pathology. 2. Department of Pneumonology E.O. Niguarda, Milan, Italy.

Various studies have laid different emphasis on prognostic factors which influence survival after resection of lung cancer. We attempt to cla- rify the prognostic value of the following morpho- logical parameters: tumor size and presence of no- dal metastases (pTN), grade of differentiation, mitotic rate, blood vessel invasion, presence of scar and invasion of the surgical bronchial mar- gin of resection in 59 consecutive cases of stage o .

I adenocarclnomas of the lung operated on in our hospital from December ist, 1978 to December ist, 1981.

The three year survival rate was 66%. There were i0 well, 25 moderately and 24 poorly

differentiated adenocarcinomas. Prognosis of the well differentiated tumors was significantly better than the poorly or moderately differentiated one (p<0,001 and p<0,001 respectively). The presence of fibrotic foci and their degree of collagenisa- tion had no significant impact on prognosis. Fur- thermore there were no significant difference in survival according to the other parameters.

Therefore the importance of a restrictive eva- luation of the grade of differentiation of the tumor is stressed, since according to our data, this seems the only morphologic parameters useful for prognostic purposes in patients operated for stage I- adenocarcinoma of the lung.

Results of TBLB and Brushing Cytology for Small

Peripheral Lung Cancer. Nakagawa, K., Matsubara, T., Kinoshita, I., Oh, S., Harashima, S., Tsuchiya, E. Cancer Institute Hos- pital, Tokyo, Japan.

Among all lung cancers resected in our institu- te since 1974, we discuss 76 cases of small peri- pheral lung cancer with a diameter less than 30 mm, which are located beyond the bronchoscopic view.