舌癌に対する凍結手術の組織学的並びに電子顕微鏡的観察--特にその作用機序と深達性についての考察
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概要
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Cryosurgery was carried out on 31 cases of the head and neck tumors (predominantlytongue cancer) and 4 cases of mammary cancer in nude mouse. In order to clarify the mecha-nism of its action and the depth of effective freezing in cancer lesions, these tumors were observed by the light and electron microscopes. 1) The surgical equipment for freezing (Type CS-45, Tohri Co. Ltd.) was used for a contact method and the IMI Spray Cryomatic Make II was for a spray method. The temperature in frozen areas was measured and recorded by the IMI Cryo-recorder. 2) In cases of freezing for 2 minutes×3 cycles and 3 minutes×2 cycles, the range of necrosis caused by freezing was well consistent with the range of ice ball formation, and the depth of effective freezing reached approximately 1.0cm. And the tissue damage by freezing was generally more pronounced in cases having received radiation or chemotherapy prior to freezing. 3) The cancer lesion was frozen for 10, 20, 30., respectively and 1, 2, 3min., respectively. Pnd the tissue specimens for electron microscopic observation were taken at the depth of 0.5, 1.0 and 2.0cm from the surface of tongue cancer and at the central as well as marginal portion of the ice ball. 4) The cell injuries by freezing in electron microscopic observation were nearly uniform in degree at the central and marginal portions of the ice ball. Severe cell damage was observed even at the depth of 1.0cm from the surface. 5) The direct action of freezing seemed to be initially the cellular damage and destruction by the ice crystals in and outside the cell. 6) Stasis of the blood capillaries and endothelial injuries were often observed in frozen cancer lesion. Ischemia was concluded to be a second factor to give rise to the complete necrosis of cancer tissue by cryosurgery.
- 一般社団法人 日本耳鼻咽喉科学会の論文