Relationship between cell composition of the pleural effusions in cancer patients and their clinical courses.(Reference to chemotherapy conduction.)

Abstract

Serial cytological examination of pleural effusionstaken from the cases with primary pulmonary carcinomas; all cases have not be done surgical resection; are studied. After diagnosis are determined, combination chemotherapy is conducted systemicallyand also intrapleuraly.1, 000 cells of one preparation are observed anddevided to (1) mesothelial cells (2) phagocytic cells (3) lynphocytes (4) neutrophilic leukocytes (5) others.Cell component ratio are compared with clinicalcondition, i.e. appetite, body weight, pain, fever, general felling, X-ray finding, biochemical date ofserum etc.Identification of cells are done by Papanicolaoustaining, Giemsa staining, PAS reaction, Peroxydasereaction, neutral red Janus green supravital staining, acid phosphatase staining, In addition to thesemethod, identification of phagocytic cells (histiocyte, monocyte) are done by means of carbon particlemethod. Conclusions are as follows:(1) In generally (before treatment), if phagocyticcells are found over 50% of all cells of the effusions, these effusion may contain the cancer cells.On the contrary, if lymphocytes are found over50% of all cells of effusions, effusions may containno cancer cell.(2) Cancer cells of the effusions are decreased bychemotherapy, but it does not always mean thegood clinical course.(3) In the period when the effusion has lymphocyteas a prominant cellular component, clinical condition shows good one. In these state, the X-ray levelof effusion does not show any change.(4) linical symptom shows rather critical duringphagocytic cell is prominant in effusion. Rapid increasing of phagocytic cells means the clinical courcemay turn for the worse process.(5) We can find the changes of cellular componentof pleural effusions before the manifestation of clinical symptoms. So, the cellular changes may be calledas a indicator for clinical course.(6) Rate of lymphocyte in pleural effusion does notrelate to the rate of lymphocyte in peripheralblood.(7) A ll cellular findings above mentioned do notrelate pH of pleural effusions.