MORPHOLOGISCHE KRITERIEN ZUM WACHSTUMSVERHALTEN DES PANKREASKARZINOMS. EXPERIMENTELLE UND KLINISCH-PATHOLOGISCHE UNTERSUCHUNGEN

In order to improve the individual characterization of ductal adenocarcinoma of the pancreas histologic and cytologic criteria of tumour differentiation were correlated with tumour growth. The most relevant parameters of grading were glandular differentiation, nuclear polymorphism and frequency of mitoses (number of mitoses per ten visual fields with magnification through the 40 objective). Using these criteria three grades of tumour (G) were separated. In 7 human adenocarcinomas of the pancreas transplanted onto nude mice GIII tumours showed a tumour replication time of approximately half of that of GI tumors. In an additional clinico-pathological study in 75 partial or total pancreas resection preparations with carcinoma of the head of the pancreas a significantly longer symptomatic time until diagnosis was found in GI tumours (n = 34) than in GII (n = 33) and GIII tumours (n = 8). Besides, GI tumours showed a generally lower staging at the time of operation than did GII and GIII tumours. The median values of postoperative survival time for GI (n = 12) and GII tumours (n = 12) with identical staging was 10.5 and 7 months, respectively. The results indicate that the suggested grading of ductal adenocarcinomas of the pancreas reflects the biological behaviour of these tumours and can thus be used as an additional prognostic parameter in staging.