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KMID : 0360319910230040728
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Journal of Korean Cancer Research Association
1991 Volume.23 No. 4 p.728 ~ p.739
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Value of PAPAN Score as Parameter of Subrenal Capsule Tumor Implant Assay in Gynecological Malignant Tumors
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姜淳範/Kang, Soon Beom
金鍾赫/鄭東根/趙慶勳/金昇喆/李孝杓/Kim, Jong Hyeok/Chung, Dong Geun/Cho, Kyeong Hoon/Kim, Seung Chul/Lee, Hyo Pyo
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Abstract
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The purpose of this study was to document that subrenal capsule tumor implant assay (SRCA) requires a histopathologic assessment of implanted tumor and whether this assessment could be an objective parameter of chemosensitive testing.
In SRCA the implanted tumor under the renal capsule showed various histopathologic changes after chemotherapy. They were regression of cancer, reduction in the number of cancer cell, tumor stroma, mitoses, and increase in tumor necrosis. These histopathologic changes were defined as PAPAN score(Preservation of cancer cells, Amount of cancer cells, Preservation of tumor stroma, Amount of mitoses, Necrosis)_ A total of 81 SRCA were performed with gynecologic malignancies against several chemotherapeutic agents or their combination and the histopathologic changes of implanted tumor were analyzed.
The results were as follows:
1) The evaluability of SRCA was 93% and cervical carcinoma was the most sensitive to EP combination chemotherapy(85%). In ovarian cancer, CAP combination chemotherapy showed 90% chemosensitivity and endometrial cancer was 100% sensitive to 5-FU and epirubicin.
2) In cervical cancer, the PAPAN score was 4.1 following 5-FU chemotherapy of which the sensitivity was 53%, 4.5 following CTX(sensitivity: 45%) and 1.7 after EP combination therapy (sensitivity: 85%).
3) In ovarian cancer, the PAPAN score was 4.4 after ´CTX(sensitivity: 40%), 2.3 following adriamycin(sensitivity: 60%) and 0.9 following CAP combination chemotherapy(sensitivity: 100%).
4) In endometrial carcinoma, the PAPAN score was 4.2 following cisplatin(sensitivity. 0%, 2.9 after CTX.(sensitivity: 40%) and 12 after 5-FU chemotherapy(sensitivity: 100%).
In conclusion, this preliminary study showed that the PAPAN score was inversely proportional to chemotherapeutic responsiveness in gynecologic malignancies.
So the histopathologic changes(PAPAN score) can be adopted as an objective parameter of SRCA for enhancing the usefulness of the SRCA as an in vivo chemosensitivity test and saving time and effort to perform SRCA.
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KEYWORD
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