Significance of Carcinoma Cells in the Blood Relative to Surgery of Pulmonary Carcinoma

¹ Assistant Professor, Department of Surgery, Tokyo Medical College
² Department of Surgery, Tokyo Medical College
³ Chairman, Department of Surgery, Tokyo Medical College

We studied 160 cases of lung cancer with respect to circulating cancer cells and obtained the following results:

1. In order to obtain accurate data, blood samples should be examined repeatedly during the patient's hospitalization. Arterial blood samples are more suitable for cancer cell detection.

2. The positive rate is higher in cases with central than peripheral tumor, and the larger the tumor, the higher the positive rate.

3. Circulating cancer cells are seldom found in coin lesions and silent phase cases.

4. Cases with hemoptysis show a higher rate. The rate is also high for cases with lymphatic metastasis, as well as with hematogenous metastasis.

5. There is a close connection between histologic malignity and the positive rate.

6. There are close connections between operability, survival rate and the preoperative positive rate.

7. Surgical manipulation during the operation is liable to isolate cancer cells and the latter migrate into the draining vein. Even in cases undergoing radical operation, cancer cells in the blood increase during the operation and are found for 40 days or longer after the resection.

8. Exploratory thoracotomy for inoperable cases should not be employed excessively, as it might accelerate migration of cancer cells into the blood.

9. Radiotherapy also tends to accelerate the isolation and migration of cancer cells.

10. Almost all cancer cells in the blood are considered ineffective as metastastic matrices, but a few circulating cancer cells still present an important problem in lung cancer therapy.